Self Help

We are keen to help patients improve on self help and hope that the following information will offer some insight into that.

Take a look and see if you can improve your own understanding of your health and well-being! Please encourage others to look here too.

Here is a list of ailments that can be safely self managed. You will see that you can take a look via the hyperlink at the other websites which can offer you further information about managing your condition.

Common ailments that can be self managed :

Acne (Spots):

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you suffer from acne (spots). It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

• What is acne? Acne tends to start at puberty and leads to greasy skin and ‘spots’. People may feel bad about themselves because of the way their skin looks, often at a time when they’re already vulnerable.
• How common is acne? You’re not alone – acne affects more than 8 out of 10 teenagers to some degree, and more frequently boys. Around one in three teenagers have acne bad enough to need treatment. In women, acne is more common around the time of their monthly periods.
• What’s causing it? Acne is caused by inflamed skin glands on your face and upper trunk, sometimes caused through an infection. In rare cases, acne may be caused by an underlying medical condition, such as polycystic ovary disease (PCO) or other hormonal disorders. It’s a myth that stress or certain foods (such as chocolate) cause acne – and acne is certainly not due to a lack of cleanliness!

What can I expect to happen?

• Duration Acne is a long-term condition that may need immediate treatment for treating severely affected skin, and maintenance therapy to keep spots from recurring. In 7 out of 10 people, acne stops within five years – but some people may suffer lifelong.
• Severity Acne can vary from being mild and localised to severe and widespread.
• Impact on your life Acne can severely affect people’s quality of life, regardless of how bad it is.
• Tests You won’t need any tests unless your doctor suspects an underlying medical cause.

What can I do myself to get better – now and in the future?

• Washing Wash your face only once or twice a day with lukewarm water. Avoid strong or abrasive soaps and excessive scrubbing. Be aware that hot water and rough flannels can make symptoms worse rather than better.
• Avoid squeezing No matter how tempting, try not to squeeze spots, as this may cause scarring.
• Over the counter creams, gels and lotions Effective treatments are available to reduce and improve spots. They can also prevent or reduce scarring if started early. Ask your pharmacist for advice on available preparations. You need to continue treatment for at least six weeks before seeing any changes. If a treatment is effective, continue for at least four to six months. You may need to try different preparations until you find one that suits you. Some treatments may irritate your skin initially, so seek advice from your pharmacist if this is the case.

When should I seek medical help?

Seek advice from your pharmacist or GP if initial treatment with over the counter preparations doesn’t work for you, if acne significantly impairs your quality of life, or if any of the following warning symptoms are present:

• Severity Your acne is really bad and you feel physically unwell because of it.
• Pain You develop painful spots that feel ‘deep’ in your skin.
• Distress You get distressed by your acne, and/or it affects your social life.
• Scarring You notice the beginning of scarring despite treatment.
• Possible underlying medical causes You suspect that you may have an underlying medical condition that causes your acne – for example, if you have additional symptoms such as infrequent or absent periods, excessive hair growth, or hair loss.

Where can I find out more?

Check out the NHS Choices website (https://www.nhs.uk/conditions/acne/) for more information on how you can treat and prevent acne. Remember that your pharmacist can also help you with assessing your symptoms and advise on suitable treatments.

Produced by the Self Care Forum (www.selfcareforum.org). Review date: May 2024

The Common Cold (adults):

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you develop a cold. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

• What is the common cold? Mild viral infections can cause symptoms of the cold, including a blocked and then runny nose, sneezing, cough, a sore throat, a slightly raised body temperature (fever) up to 39°C and feeling generally unwell.
• How dangerous are colds? Colds are harmless and in the vast majority of cases get better by themselves without any complications. If you have a long-term health problem (such as diabetes, heart disease or a lung condition) or a weakened immune system (for example due to chemotherapy) you may need to get advice from a member of your pharmacy team, or your GP.
• How common are they? Colds are very common, and adults get an average of two to four colds a year.
• Are there any complications? While the symptoms are unpleasant, the common cold is harmless. Complications, such as chest, ear and other infections, are rare.
• Will I need antibiotics? Most colds get better on their own without treatment. Antibiotics are ineffective for treating the common cold and may cause side effects.
• Effect of smoking: Cold symptoms such as coughing tend to be more severe if you smoke, and the infection usually lasts longer.

What can I expect to happen?

• Symptoms: In adults and older children, cold symptoms last for about a week and a half, and in younger children for up to two weeks. Symptoms are usually worst in the first two to three days, before they gradually start to improve. Coughs may last up to three weeks.
• There is no cure: We have no cure for the common cold. But while our bodies fight the infection, there are various ways of relieving our symptoms.
• Catching a cold: We can catch a cold by either breathing in droplets of fluid containing the cold virus (when someone sneezes), or by touching something that someone has sneezed on, and then touching our mouth or nose.

What can I do – now and in the future?

• Simple measures: Get some rest until you feel better – we usually know when we’re well enough to return to normal activities.
• Diet and fluids: Eat healthily, including at least five portions of fruit and vegetables every day. Drink plenty of fluids to replace those lost from sweating and a runny nose.
• Over the counter medicines: Paracetamol, ibuprofen or aspirin can help reduce the symptoms of a cold. Avoid giving aspirin to children under the age of 16 and follow the manufacturer’s instructions. Talk to your pharmacist about supplements that may help ease your symptoms.

When should I seek medical help?

Most colds are not serious and get better by themselves. Contact your GP surgery for urgent advice if you notice one or more of the following:

• You develop a high temperature (above 39°C or 102.2°F), which can be a sign of amore serious type of infection;
• You’re feeling confused or disorientated;
• You notice a sharp pain in your chest;
• You cough up blood-stained phlegm (thick mucus);
• You find it difficult to breathe;
• You notice a marked swelling of the glands in your neck and/or armpits;
• Your symptoms last longer than three weeks.

Where can I find out more?

Visit NHS Choices (http://www.nhs.uk/Conditions/Cold-common/Pages/Introduction.aspx) or Patient.co.uk https://patient.info/chest-lungs/cough-leaflet/common-cold-upper-respiratory-tract-infections for more information on what you can do if you suffer from a cold. Remember that your pharmacist can also assist you in assessing your symptoms.

Produced by the Self Care Forum (www.selfcareforum.org). Review date: May 2024

Constipation:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if your stools – or, less formally, poo – are too hard and/or difficult to pass (known as constipation). It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

• What is constipation? Constipation is when your stools become hard and you find it more difficult than usual, or even painful, to pass them when going to the toilet. You may also have a feeling of being unable to completely empty your bowel. Opening your bowels may be more difficult because your stools are hard, lumpy and dry, or because they are abnormally small or large.
• Other symptoms Constipation may be accompanied by feeling bloated or sick, losing your appetite, and aches or cramps in your abdomen.
• How common is it? You’re not alone – constipation is very common (particularly in women and older people) and affects an estimated one to two out of 10 people at any one time.
• Common causes These include not eating enough fibre (contained in cereals, vegetables and fruit), changing your eating habits, ignoring the urge to go to the toilet, not drinking enough fluids, not getting enough exercise – and, perhaps surprisingly, also mental health problems such as depression or anxiety. Certain medications, such opiates, diuretics and antidepressants may also cause you to become constipated.
  

What can I expect to happen?

• Normal stool frequency We’re all different when it comes to bowel habits – some of us pass stools only every three or four days, whereas others may go more than once a day.
• Constipation is usually harmless Being constipated once in a while is common and usually completely harmless.
• Duration In most cases, constipation is short-lived and settles within a few days – or 2 to 4 weeks at the most.
• Investigations There is usually no need for any investigations or procedures, because the diagnosis can often be made based on the symptoms alone.

Where can I find out more?

NHS Choices (http://www.nhs.uk/Conditions/Constipation/Pages/Introduction.aspx) and

the Choose Well website (www.choosewellmanchester.org.uk/self-care) provide

further useful information about constipation. Remember that your pharmacist can also help.

Produced by the Self Care Forum (www.selfcareforum.org). Updated Aug 2022, Next Review due: Aug 2024

Cough in Adults:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you develop a cough. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

• Types of cough A cough may be acute, lasting less than three weeks, or chronic, when it may go on for more than eight weeks. Cough can also be dry or productive of sputum (phlegm).
• Frequency Most adults experience episodes of coughing between two and five times a year, and about one in five people suffer from coughs during the winter months.
• Rarely serious Although coughing often impairs people’s quality of life, it israrely due to serious causes and usually gets better by itself.
• What causes coughs? Acute cough is most commonly caused by a viral upper  respiratory tract infection (URTI) due to a cold. A chronic cough is common in smokers and can sometimes suggest an underlying lung problem, but may also be caused by conditions outside the lung, such as heartburn (gastric reflux). Cough may also result from taking certain drugs (check the label), asthma, and environmental factors (dusty workplaces, for example).

What can I expect to happen?

• Coughing is usually harmless Although a cough can be distressing (both for yourself and others living or working with you), acute coughs that are not coronavirus- related tend to be harmless and usually improve within three weeks.
• No need for antibiotics Antibiotics do not work against viral infections, which cause most acute coughs, and so they may do more harm than good.
• Duration You may easily suffer a dry cough for 3 to 4 weeks after an infection has settled.
• Tests You don’t normally need any tests if you suffer from an acute cough.

What can I do myself to get better – now and in the future?

• Paracetamol and ibuprofen: Paracetamol and ibuprofen can help with relieving symptoms that may come with a cough and cold, such as a sore throat, fever, and not feeling well. Always read the label and instructions before using them.
• Cough mixtures and medicines: For many over the counter medicines we don’t know how well they work, but you may still find them useful. A herbal medicine, pelargonium is sometimes used for over 12s as are cough remedies containing guaifenesin. Speak with a member of your pharmacy team.
• Home remedies: Simple home remedies, such as ‘honey and lemon’ can help. Add freshly squeezed juice from half a lemon and one to two teaspoons of honey to a mug of boiled water and drink while still warm.
• Water: Drink at least six to nine glasses of water in a day, especially if you feel thirsty.
• Rest: Get plenty of rest.
• Stop smoking: Smoking is a common reason for an ongoing cough. If you can stop smoking – or at least smoke less – your cough is likely to get better in the long-term. You’ll feel better and your health will also benefit in other ways – visit the NHS Website for details or speak to a member of your pharmacy team about how to quit

When should I seek medical help?

A new continuous cough may be coronavirus – see section above before reading further.

Seek medical advice if you feel more unwell than you’d expect or if you notice any of the warning symptoms below

• Severity: Your cough is really bad or gets worse quickly – especially if it’s a ‘hacking’ cough or you can’t stop coughing;
• Duration: Your cough lasts longer than three weeks;
• Foreign body: You cough after you’ve choked on something;
• Chest or shoulder pain: You have chest and/or shoulder pain
• Breathlessness: You also find it harder to breathe, or you breathe faster than normal;
• Blood: Seek medical advice if you cough up small amounts of blood. If you cough up larger amounts, seek medical advice urgently;
• Swollen glands: The side of your neck feels swollen and painful;
• You have a weakened immune system: For example, through diabetes or chemotherapy.

Where can I find out more?

Check out NHS Choices (http://www.nhs.uk/conditions/Cough/Pages/ Introduction.aspx) or the Choose Well website (www.choosewellmanchester.org.uk/self-care) for more information on how you can treat and prevent cough. Remember that your pharmacist can also help you with assessing your symptoms.

Produced by the Self Care Forum (www.selfcareforum.org). Review date: May 2024

Eczema:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you or your child suffer from atopic eczema (atopic means ‘sensitivity to allergens’). It also tells you when you should become concerned and when it’s best to seek medical advice from a health professional. When talking of eczema, we mean atopic eczema in this fact sheet.

Useful facts

• What skin changes does eczema cause? If you suffer from eczema, your skin can appear red (or darker, if you have dark skin), swollen, crusty and cracking. Itching is common and often caused by skin dryness, infection, allergens or scratching.
• How common is eczema? Eczema is a dry skin condition that can persist or seem to go away and then come back again. It affects about 2 out of 10 children and 2 to 10 out of every 100 adults in the UK
• What’s causing it? Eczema tends to start in childhood and is influenced by genetic and environmental factors. People with eczema often suffer other allergic conditions as well, such as asthma or hay fever, or both. Food allergy may sometimes be responsible in children who present with more severe eczema early in life.

What can I expect to happen?

• How bad can eczema get? The severity of eczema can range from mild to quite severe. Around eight out of 10 children have mild eczema, with episodic flare ups.
• Will I get cured? Eczema in childhood is a condition which tends to come and go. The good news is that in most children, eczema will gradually improve. Around 60% of children who have eczema in the first few years of their lives are clear of it by the age of 11, but, we cannot say which children will clear or when, and some children may have an eczema tendency for life, even if it improves with age. While there is no known cure there are effective treatments which can alleviate symptoms and reduce inflammation.

What can I do myself to get better – now and in the future?

• Avoid trigger factors Environmental allergens (such as dust-mite antigens or pollen), irritants (such as detergents or dirt), certain foods, pet dander, smoke, certain weather conditions and stress may all impact on eczema. Try to find out whether any of these impact on your eczema and minimise them.
• Avoid soap Avoid soap and bubble bath, as both can dry out the skin. Use emollients as soap substitutes.
• Avoid scratching too hard Scratching is a natural reflex, but scratching too hard can make the itch even worse (the ‘itch-scratch cycle’). So whenever possible, avoid scratching your skin too hard with your fingernails – even if it’s tempting. Instead, rub itchy patches gently with your fingertips.
• Avoid temperature extremes Hot and cold temperatures may also make your eczema worse. So dress appropriately for hot and cold environments, or try to avoid temperature extremes altogether.
• Use non-irritant garments Synthetic garments and wool can trigger eczema, so you may prefer wearing clothes made out of cotton or other non-irritant materials.
• Moisturisers Eczema causes the skin to become dry, and the dryer the skin becomes, the higher the chances that your symptoms will get worse. So try to keep your skin as hydrated and smooth as possible by using your moisturising creams or ointments regularly and liberally, even when your skin appears ‘clear’.
• Inflammation and flare-ups Speak to your pharmacist about how you can step up/down treatments. Antihistamines can help with itching.
• Detergents Avoid using fabric conditioners and consider adding an extra rinse cycle when using a washing machine.

When should I seek medical help?

Contact your GP surgery when you feel you need help. Rarely, eczema needs more urgent assessment and treatment, so seek medical advice if you notice any of the following:

• Reduced quality of life Your skin problems severely affect your sleep or impair social activities such as swimming.
• Infection Cracking, weeping and painful skin may suggest infection.
• Blistery rash You develop a painful blistery rash, which may be due to an infection with the herpes simplex virus.
• Spread Larger areas of your body, such as most of your chest, back, or limbs become dry and/or red.

Where can I find out more?

There’s a lot you can do to relieve symptoms if your eczema gets worse. Check out NHS Choices (http://www.nhs.uk/Conditions/eczema- (atopic)/Pages/Introduction.aspx) and the National Eczema Society website (www.eczema.org) as well as www.nottinghameczema.org.uk for further information on how you can treat and prevent eczema. Remember that your pharmacist can also help you with assessing and treating your symptoms.

Produced by the Self Care Forum (www.selfcareforum.org). Updated Feb 2024, Next review due Feb 2026

Fever in Children:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if your child develops a fever. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

• What is fever? Fever is a raised body temperature above the normal daily variation, which usually suggests an underlying infection. A high temperature is 38°C or higher.
• Fever is often ‘normal’ Mild feverish illness is a normal part of childhood – a natural, healthy and harmless response to help the body fight infection.
• Fever is common Between around 3 out of 10 pre-school children develop at least one episode of fever every six to 14 months.
• Common causes Common causes of fever include the common cold, ear infections, stomach bugs (gastroenteritis), throat- and travel-related infections.
• Serious causes Severe infections, such as pneumonia or meningitis, are in rare cases the main cause of a fever.
• Children under six months Any child under six months of age with a fever should be assessed by a health professional.

What can I expect to happen?

• Fever gets better by itself In most cases, fever is due to a common and harmless illness that gets better by itself – and your child won’t need antibiotics.
• Duration Fever should not last for longer than five days. What can I do to help my child – now and in the future?
• Check your child’s temperature In children aged between four weeks and five years, use either an electronic or chemical dot thermometer in your child’s arm pit, or an infra-red tympanic thermometer in the ear canal. If you haven’t got a thermometer, use your judgement as to whether your child feels abnormally hot.
• Clothing Avoid over- or under-dressing your feverish child.
• Heating and cooling Keep your central heating down. Tepid sponging of children is no longer recommended.
• Fluids Offer your child regular fluids. If you’re a breastfeeding mother, offer your child as many feeds as she/he will take.
• Body checks Check your child at night for signs of serious illness (see over).
• Schooling/nursery It is best to keep feverish children away from nursery or school while the fever persists.
• Medication You can give either paracetamol or ibuprofen if your child is unwell or appears distressed. Neither should be given routinely just to reduce body temperature or with the aim of preventing fits. Do not give your child paracetamol and ibuprofen at the same time unless advised to do so by a health professional. If you child is still distressed before the next dose of one of these medicines is due, you can consider using the other.

When should I seek medical help?

Contact your child’s surgery or call 111 in England and Wales, the Phone First Service in NI or NHS24 in Scotland NOW if your child has any of these

• High fever If your child is 3-6 months old and has a temperature of 38°C or more or you think they have a high temperature.
• Vomiting Your child vomits repeatedly, or brings up dark-green vomit.
• Skin colour Your child’s skin, lips or tongue are pale.
• Rash You notice a new rash that blanches when a tumbler is pressed against it.
• Behaviour Your child doesn’t respond normally, wakes with difficulty, is less active, doesn’t smile or feed poorly or is not their usual self and you are worried.
• Breathing Your child breathes much faster than usual and their nostrils flare.
• Hydration Your child doesn’t eat or drink much and doesn’t pass as much urine. Nappies stay dry, her/his mouth and eyes appear dry.
• Duration Your child’s fever has persisted for 5 or more days.
• Other signs Your child also can’t walk for some reason, has developed a swelling or new lump in a limb or joint or has attacks of shivering or you notice any other unusual symptoms and signs that you can’t explain, or your child is less well than when you previously sought advice.

Call NHS111 or go to A&E if your child has a temperature and any of these symptoms

• High fever If your child is 3 months old or less and has a temperature you have measured of 38°C or more or you think they have a high temperature.
• Skin colour Your child’s skin, lips or tongue are mottled/ashen/pale or blue.
• Behaviour Your child does not respond, does not wake, or falls asleep again if woken or has a high pitched or continuous cry or is very agitated or confused.
• Breathing Your child breathes much faster than usual, makes a grunting sound when they are breathing, and the skin between the ribs or the area just below the rib cage moves in and out during breaths.
• Hydration If your child has a dry mouth, if you pinch the skin on the back of your child’s hand and it does not return to normal quickly or, in babies, the soft spot on the top of the head (the fontanelle) is sunken or bulges.
• Rash You notice a new rash that doesn’t fade on pressure (press a tumbler against the rash to see if it disappears).
• Other signs Your child has a stiff neck, is bothered by light, has cold hands or feet or has had a fit or seizure for the first time (can’t stop shaking).

Where can I find out more?

Check out the NHS Choices website (http://www.nhs.uk/Conditions/feverchildren/Pages/Introduction.aspx) for more information on how you can manage fever in children.

Produced by the Self Care Forum (www.selfcareforum.org). Last updated June 2022, Next review due June 2024

Headaches & Migraines:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you develop an occasional headache. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

• Common types of headache: The most common headache is tension-type headache – the one we think of as ‘ordinary’ or ‘everyday’ headache. Tension headache tends to be mild to moderately severe and affects both sides of the head. It usually feels ‘pressing’ or ‘tightening’ and is not aggravated by routine daily activities. Migraine is a moderate or severe throbbing headache affecting one or both sides of the head and made worse by ordinary daily activities.
• Less common causes of headache: These include cluster headache (a severe or very severe pain around and above the eye), headache from overusing pain killers (¹affecting about one to two out of 100 people), inflamed blood vessels, and raised pressure inside the head (for example from a bleed or tumour).
• Headaches are common: Tension headaches are very common and most people get them from time to time.  15 per cent of adults in the UK suffer from migraines².
• Migraine triggers: Migraines can have many triggers, such as certain foods, stress, hunger, tiredness. Changes in the menstrual cycle, menopause and contraception can have an impact on migraines.

What can I expect to happen?

• Rarely serious: Although headaches can severely affect your life, they’re rarely serious or life-threatening. Most get better by themselves, often within 24 hours.
• Tests: You won’t usually need further tests, such as scans or blood tests

What can I do myself to get better – now and in the future?

• Headache diary:  Keep a headache diary and record how often you get headaches, how long they last, and whether they are mild, moderate or severe.
  • This can be helpful to decide whether your headaches follow a particular pattern and shows how they respond to treatment, which is useful when you need to discuss them with a health professional.
  • A headache diary can also be used to identify and help you manage triggers.
  • A useful online version for monitoring migraine headache is available on the Migraine Trust website: https://migrainetrust.org/live-with-migraine/self-management/keeping-a-migraine-diary/
• Lifestyle: Try to keep a regular sleep pattern and exercise regularly.
• Diet and fluids:  Drink at least 6 to 8 glasses of fluid (ideally water) a day. Avoid alcohol and take regular meals.
• Painkillers:  Various painkillers are available without prescription from your pharmacist. Choosing a preparation often comes down to personal preferences and needs to take into account other medical conditions that you may have, other medicines that you may be taking, and the risk of potential side effects. Special migraine medications are available for treating migraine attacks on prescription from your GP . Avoid taking painkillers for headaches for more than 10 to 15 days per month as this can also cause headaches.
• Other treatments: Acupuncture can help with migraine and tension type headache. Riboflavin, magnesium and co-enzyme Q10  (available as food supplements from health food shops) may help reduce migraine frequency and intensity in some people. Manual therapy may help if you also suffer from neck aches. 

When should I seek medical help?

Seek medical advice if over the counter treatments don’t relieve your symptoms, or if you find it difficult to get on with your daily activities or go to work. Also speak to a health professional if you notice any of the following:

• Frequency: Your headaches become more and more frequent.
• Additional symptoms: You vomit for no apparent reason or have a high fever. You develop a stiff neck or feel drowsy.
• After head injury: You suffer from persisting headaches after a blow or other injury to your head (though a mild headache for one to two days after a head injury is common and usually harmless).
• Sleep: Your headache prevents you from getting to sleep or wakes you.
• Certain situations: Your headache is worse on coughing, straining, bending, lying flat or laughing.
• Speech and personality: You notice a change in speech or personality.
• Odd sensations: You develop weakness, numbness or other odd sensations anywhere on your body, or you feel unsteady on your feet.
• Severity: You develop a sudden severe headache, like ‘being hit with a hammer’.
• Eyes: Your eyes feel really uncomfortable when looking at bright light, or you suffer other new eye symptoms, such as sudden blind spots.
• Other symptoms: You have muscle pains, pain on chewing, a tender scalp, or feel unwell.

Where can I find out more?

NHS Choices (http://www.nhs.uk/conditions/headache/Pages/Introduction.aspx) and the Pain Toolkit (www.paintoolkit.org) have more information on how you can treat and prevent headache. Your pharmacist can also help you with assessing your symptoms.

Produced by the Self Care Forum (www.selfcareforum.org). Last updated October 2022, Next review due October 2024

Heartburn and Indigestion:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you suffer from heartburn or indigestion (also called dyspepsia). It also tells you when you should become concerned and when it’s best to seek medical advice from a health professional.

Useful facts

• Dyspepsia is common  The symptoms in the upper abdomen described below affect an estimated 4 out of 10 people in any one year.
• How does it present? Heartburn and indigestion is often first noticed as burning pain or discomfort in the upper abdomen or chest. It can also create an unpleasant sour taste in your mouth, from stomach acid.
• Timing Symptoms typically occur after meals and can be exacerbated when lying down or bending over.
• Other problems Dyspepsia is commonly accompanied by belching, feeling bloated or sick, or experiencing coughs or hiccups that keep coming back.
• What causes dyspepsia? Common causes include acid reflux where stomach acid flush from your stomach into your oesophagus (food pipe or gullet)

Acid reflux can be caused by certain foods and drinks, being overweight, smoking, stress, and pregnancy.

It can also be caused by inflammation of the food pipe by certain medicines including ibuprofen (check the patient information leaflet), or when part of the stomach squeezes through the diaphragm muscle into the chest (known as hiatus hernia).

Less commonly, a stomach ulcer or cancer of the stomach or oesophagus may be responsible.

Sometimes, no underlying cause can be found. This is known as functional dyspepsia.

What can I expect to happen?

• Duration Your symptoms will usually improve within 1 or 2 weeks. But if you find that you keep taking indigestion medicines all the time for several weeks or that your symptoms affect your day-to-day life, consult your GP.
• Effect of changing your diet In about 8 out of 10 people, symptoms will improve by making lifestyle changes alone, such as healthier eating and losing weight. Avoid fatty and fried meals and eating large meals within 3 to 4 hours before sleeping. Also try to avoid carbonated soft drinks, caffeine, and alcohol. Eat slowly and chew properly.
• Medication If lifestyle changes alone don’t work, you can expect your symptoms to improve by taking over-the-counter (OTC) such as antacids or alginates, or with prescribed medication.
• Investigations Most people do not need any tests. But if your symptoms are not controlled, or your GP suspects an underlying cause, you may need further testing. This could include blood tests, a stool test to check your stomach for the Helicobacter pylori bacteria or referring you for an endoscopy which looks into your oesophagus and stomach with a thin and flexible tube-like camera.

What can I do myself to get better – now and in future?

• Smoking and Alcohol Reducing or stopping smoking and alcohol intake may help improve your symptoms.
• Weight loss Losing weight if you are overweight or obese will likely improve your symptoms
• Avoid trigger foods Coffee, chocolate, tomatoes, fatty or spicy foods can all worsen your symptoms. Eating smaller meals at least 2- hours before bedtime will also help.
• Over the counter medicines Various drugs that neutralise the acid in your stomach (antacids) as well as other drugs called H2-receptor antagonists and proton pump inhibitors (PPIs) are available without prescription at pharmacies. It is best not to take these medicines for a long time without consulting a pharmacist or other health professional.
• Avoiding aspirin-like drugs If you take OTC anti-inflammatory pain killers, such as aspirin or ibuprofen, regularly, consult a health professional in case these could be the cause of the indigestion.

When should I seek medical attention?

Rarely, more serious medical problems may cause indigestion – particularly if you are aged 55 or over. Seek medical advice if your symptoms last for most days for 3 weeks or they do not respond to treatment or you notice any of the following:

• Pain and other chest/stomach symptoms You suffer from severe, persistent (longer than 3 weeks), worsening and unexplained pain in your upper abdomen – particularly if occurring together with other symptoms, such as pain in your chest, breathlessness, sweating, feeling sick or vomiting.
• Vomiting blood or persistent vomiting You vomit blood or dark lumps (like ‘coffee grounds’) or you are persistently vomiting.
• Dark stools (poo) Your stool colour has become very dark (looking like tar). But remember that if you take iron tablets your stool can also become black – a harmless side effect which will go when you stop taking iron.
• Feeling faint You feel faint, or you’ve collapsed.
• Swallowing problems You develop difficulties with swallowing.
• Other problems You suffer from unexplained fever, night sweats, unintentional weight loss, or you notice a swelling or mass in your upper abdomen.

Where can I find out more?

NHS Choices (http://www.nhs.uk/conditions/indigestion/Pages/Introduction.aspx) has more information on how you can treat and prevent indigestion. Remember that your pharmacist can also help you with assessing your symptoms.

Produced by the Self Care Forum (www.selfcareforum.org). Next review due October 2024

Urine symptoms in men:

This fact sheet helps you to know what’s ‘normal’ and what you can do to help yourself if you are affected by urinary symptoms, such as passing urine very often, getting up at night more than once or twice to pass urine, a slow urinary stream, or having to rush to the toilet a lot of the time. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

• How common are they? Many men develop problems with storing or passing urine (urinary symptoms) as they get older. Up to half of adult men have some urinary symptoms up to the age of 40, while 66 out of 100 men between 40 and 60 and over 75 out of 100 men aged over 60 are affected.
• What causes them? Many men with symptoms worry about prostate cancer, but an enlarged prostate (called benign prostatic hyperplasia) is much more common – and the two are not linked. Not all urinary symptoms are caused by the prostate gland, although it is often blamed. Diabetes, Urinary Tract Infections (UTIs), Sexually Transmitted Infections (STIs) as well as bladder cancer can also cause urinary symptoms.   
• Will I need treatment? Treatment for urinary problems is dependent on the underlying cause and is often aimed at improving symptoms. So, if you’re not too concerned by your symptoms, you can often manage them very simply by making a few changes to your lifestyle.

What can I expect to happen?

• Duration Most urinary symptoms are long-term and will stay the same or slowly worsen, unless they are caused by an infection (UTI).

What can I do to get myself better – now and in the future?

• Keep a drink diary for a few days: Look at what you drink during a typical day. It can be useful to keep a diary for a few days, making a note of:
  • what you drink (for example tea, coffee, alcohol and water)
  • the amount you drink (use a measuring jug or estimate the volume – a typical mug holds approximately 250mls)
  • the time of day when you drink
• Fluid intake: Aim to drink between 1500 and 2000mls per day. Many people think that they need to drink large amounts of fluid each day for good health, but this is untrue and will often make urinary symptoms worse.
• Avoid stimulants: If you drink large amounts of tea, coffee, fizzy drinks or alcohol, try cutting these down as they can increase urinary symptoms. Even decaffeinated tea or coffee can cause problems, so try switching to mainly water, fruit juice, squash or herbal teas and see how this impacts on your symptoms.
• Avoid drinks before bedtime: If you wake during sleep to pee and you find this troubling, look at your fluid intake before you go to bed. Try to decrease the amount of drinks before you go to sleep, and particularly avoid tea, coffee and alcohol. This can make a big difference.
• Massage: If you leak urine into your underwear after peeing, this simple technique may help: press upwards on the area between the sack containing your testicles and your back passage after peeing and massage gently upwards and forwards – this can push out the last bit of urine and prevent leakage.
• Bladder training: If you pee too frequently or have to rush to go to the toilet, consider some simple bladder training techniques.  See “where can I find out more?” for links. 
• Exercise more: Increasing your level of physical exercise and losing weight can reduce urinary symptoms and also improve other aspects of your health.
• Over the counter (OTC) products: Tamsulosin can be bought at pharmacies. It can help if an enlarged prostate is causing a slow urinary stream. Visit the link below for more information. See your GP within 6 weeks of starting this medicine if you buy it yourself, to make sure it is Ok for you to continue. Avoid herbal medicines until you’ve seen your doctor or pharmacist.

Incontinence products help but your problems may be treatable. Your pharmacist or doctor can advise.

When should I seek medical help?

Contact your GP surgery for advice if you:

• Develop new urinary symptoms, particularly if they worsen quickly.
• Have cloudy or smelly urine, or if peeing stings (this may suggest infection).
• Find your urinary symptoms troubling and OTC medicines don’t help.
• See blood in your urine – this can be a sign of bladder, kidney or prostate cancer.
• Leak urine (called incontinence).
• Have difficulty with erections – this is common in men with urinary symptoms.
• Worry about prostate cancer, particularly if this runs in your family.

Where can I find out more?

To learn more, go to Patient.co.uk at http://www.patient.co.uk/health/lowerurinary- tract-symptoms-in-men, Prostate Cancer UK at www.prostatecanceruk.org and Your Prostate at www.yourprostate.eu for further information. To discuss any problems with a specialist nurse, you can call a free helpline on 0800 074 8383.

Produced by the Self Care Forum (www.selfcareforum.org). Last updated October 2022, Next review due October 2024

Middle ear infection (acute otitis media) in children:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if your child develops an infection of the space behind the ear drum (‘middle ear infection’, or acute otitis media). It also tells you when you should become concerned and seek advice from a health professional. Middle ear infection mainly affects children.

Useful facts

• What is middle ear infection? Behind the ear drum is a small space that’s usually filled with air: the middle ear. When germs (such as viruses or bacteria) enter, for example during a cold, an infection can develop. Middle ear infection is also known as “acute otitis media”.
• How dangerous is it? In most children, it is a harmless infection that gets better by itself within 3-7 days without any complications.
• How common is it? Middle ear infection is very common, mostly affecting children. More than half of all children suffer at least one middle ear infection by the time they’re 7. Symptoms usually last 3 days but can last up to 7. Most children and young people get better within 3 days without the need for antibiotics.
• Who’s affected? Middle ear infections are more common in children who breathe in tobacco smoke, attend day care (nursery,) or who drink formula milk rather than breast milk.
• What are the symptoms? Older children usually complain of ear ache, while younger children often pull or rub their ears. It is common to get a fever, but not usually above 38°C. Other common symptoms in small children include being irritable, crying, disturbed sleep, cough, snuffly nose and poor feeding.
• Does my child need antibiotics? Most children with a mild middle ear infection will not benefit from antibiotics. Antibiotics may be prescribed if your child is very unwell (eg high fever and/or vomiting), if they are considered at risk of complications, if they develop a leaking ear, or, in children younger than 2 years, have infections in both ears. Your child may be prescribed ‘back up’ antibiotics, to be started only if they do not improve or become more unwell.

What can I expect to happen?

• Symptoms: Symptoms of middle ear infection tend to develop quickly and usually last 3 days, but can last 7 days. Most children and young people get better within 3 days without the need for antibiotics.
• Fluid leaking from the ear: A hole may form in the ear drum and cause infected thick fluid (pus) to run out of the ear. This usually relieves the pain as it reduces the pressure on the ear drum.

What can I do to help my child – now and in the future?

• Giving painkillers: You can give either Paracetamol or Ibuprofen if your child is unwell or appears distressed. Do not give both at the same time unless advised by a health professional. You can try the alternative medicine if your child does not respond to the first one you start with. Always follow the manufacturer’s instructions. Do not give Aspirin to children under the age of 16. Don’t give antihistamines or decongestants.
• Wipe away discharge: Wipe any discharge away but do not put anything in the ear, including cotton buds and fingers.
• Keep your child cool: Avoid over or underdressing a feverish child. Keep your central heating down. Tepid sponging is not recommended.
• Fluids: Offer your child regular fluids. If you’re breastfeeding, offer as many feeds as your child will take. Avoid dummies and feeding while lying flat.
• Body checks: Check your child at night regularly for signs of serious illness.
• Use a warm or cold flannel: A warm or cold flannel applied to the ear can help.

When should I seek medical help?

Most ear infections are not serious and get better by themselves. Contact your GP surgery for urgent advice if you notice one or more of the following:

• High fever: A body temperature over 39°C in older children, particularly if aged between 3-6 months of age
• Vomiting
• Not improving: Your child becomes generally unwell or doesn’t start to improve after 3 days.
• Fluid: Fluid leaks out of the ear.
• Existing conditions: If your child has a long term medical condition such as diabetes or a weakened immune system, for example due to chemotherapy.
• Regular ear infections: contact your GP if your child has regular infections or if any hearing loss does not improve after an infection.
• Swelling: You notice any swelling around the ear.

Where can I find out more?

Visit NHS Choices (http://www.nhs.uk/conditions/otitis-media/Pages/Introduction.aspx) or www.patient.co.uk for more information on what you can do if your child has symptoms of a middle ear infection. Remember that your pharmacist can also assist you in assessing your child’s symptoms.

Produced by the Self Care Forum (www.selfcareforum.org). Last updated June 2022, Next review due June 2024

Acute sinusitis (adults):

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you develop sinusitis. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

• What are sinuses? Sinuses are cavities in our face bones that open up into the nose, helping to control the water content and temperature of the air reaching our lungs.
• What is sinusitis? The body’s response to irritants or bugs (inflammation) can lead to sinusitis: a swelling and irritation of the lining of the sinuses. Viral infections, such as the common cold, can cause the lining of the nose to swell, blocking the small opening from the sinuses to the nose. Fluid inside the sinuses may build up, which can make you feel bunged up and stuffy.
• What types are there? Sinusitis can be acute (resolving within 2 or 3 weeks) or chronic (which can last longer than 12 weeks).
• What are the symptoms? The most common symptoms include a blocked or runny nose, pain and tenderness in the face, and a raised body temperature. Additional symptoms are headache, cough, pressure in your ears, feeling generally unwell, bad breath, tiredness, and reduced taste and smell.
• Will I need antibiotics? The symptoms of sinusitis usually get better on their own without treatment. Antibiotics are unlikely to help unless the symptoms are severe.

What can I expect to happen?

• Duration: The symptoms of acute sinusitis last longer than the common cold and improve within 2 or 3 weeks. Although, chronic sinusitis may last for months.
• Need for treatment: In most people, sinusitis will get better without treatment, and about most people with sinusitis won’t need to see their GP.

What can I do to get myself better – now and in the future?

• Simple measures: Rest, applying warm face packs and washing out the nose with a steady stream of saline solution (available from your pharmacy) may help relieve your symptoms.
• Fluids and food: Drink plenty of fluids to replace those lost from sweating and a runny nose. Get some rest until you feel better – we usually know when we are well enough to return to normal activities. Eat healthily, including at least five portions of fruit and vegetables every day.
• Over the counter medicines: Paracetamol, ibuprofen or aspirin can help reduce the symptoms of sinusitis. Avoid giving aspirin to children under the age of 16 and follow the manufacturer’s instructions. A decongestant preparation for your nose (for a maximum of one week) can help if a blocked nose is the problem.
• Not recommended: Complementary and alternative medicines, steam inhalation, and drugs such as antihistamines, mucolytics and steroids are currently not recommended.

When should I seek medical help?

Contact your GP surgery for urgent advice if you notice one or more of the following:

• If you develop a high temperature (above 39°C or 102.2°F), which can be a sign of a more serious type of infection
• You are confused or disorientated;
• You feel really unwell;
• You are at high risk of complications because you suffer other medical conditions;
• You suffer severe pain or discomfort in your face;
• Your nose produces lots of thick green/yellow fluid.

Where can I find out more?

Visit NHS Choices (http://www.nhs.uk/Conditions/Sinusitis/Pages/Introduction.aspx) or Patient.co.uk https://patient.info/ears-nose-throat-mouth/acute-sinusitis for more information about sinusitis. Remember that your pharmacist can also assist you in assessing your symptoms.

Produced by the Self Care Forum (www.selfcareforum.org). Last updated October 2022, Next review due October 2024

Sprains and strains:

This fact sheet helps you to know what’s ‘normal’ and what you can expect to happen if you suffer a sprain or strain. It also tells you when you should become concerned and seek advice from a health professional.

Useful facts

• What is a sprain? Sprains are due to injured ligaments and often affect the ankle, wrist, thumb and knee. Typical symptoms include pain around a joint, swelling, tenderness, bruising and not being able to use the joint normally or put weight on it. Swelling often occurs almost immediately but the onset of bruising may be delayed.
• What is a strain? Muscle strains are caused by over-stretching or tearing of the muscle and are common in the legs and lower back. Muscle strains usually lead to pain and swelling, bruising, and reduced limb function.
• How common are they? Sprains and strains are common, but often go unreported. Ankle sprain is the most common type of sprain, and often occurs during sports.
• What can reduce the of risk sustaining a sprain or strain? Wearing appropriate footwear, properly warming up before exercising, using good exercise technique and proper use of equipment.

What can I expect to happen?

• How long will my symptoms last? Most sprains and strains get better by themselves and usually get better within four to six weeks with little risk of long-term complications.
• When will I be fit again? Most people will be able to return to full sporting activities at around 12 weeks. However, some severe injuries of larger muscles may take several months to heal.
• Will I need any tests? Most sprains and strains are diagnosed through clinical history-taking and examination. Your doctor may consider further assessments or tests, such as an X-ray or scans, if complications or a fracture (broken bone) are suspected.

What can I do myself to get better – now and in the future?

• PRICE & HARM: Protect the affected limb, Rest it for 48-72 hours, and use Ice as soon as possible after the injury. Using Compression bandages and Elevating (raising) the limb can also reduce swelling. Avoid Heat, Alcohol, Running (or any other form of exercise) and Massage (HARM) in the first 72 hours after an injury.
• Exercises for sprains: As soon as pain allows, gently move the joint in all possible directions to increase and maintain flexibility. Physiotherapy exercises for ankle sprains can be useful.
• Immobilising the sprained joint can delay recovery. An exception is in severe ankle sprains, where immobilisation with a brace or cast for 10 days can support recovery.
• Rest for strains: For strains it is best if you keep the affected muscle still for a few days after the injury before starting to move it again. Do gentle stretching and strengthening exercises and wear appropriate footwear at home, work and when you take part in sports.
• Pain relief: Oral and topical (rub-on) anti-inflammatory painkillers are widely available over-the-counter (OTC). These can be used to relieve pain and reduce swelling. If you need help with these talk to a member of your pharmacy team.

When should I seek medical help?

Seek further medical advice if you’ve suffered a severe sprain or strain that may suggest a broken bone or joint dislocation, if your pain is not controlled by over-the-counter medication, or if your sprain or strain does not get better as expected.

Warning symptoms and signs include:

• Severity: Your pain is severe and not controlled by OTC medication;
• Duration: Your symptoms don’t start to improve after three to four days of self-treatment;
• Walking: You can’t walk because of your injury, or an affected leg ‘gives way’ and makes you walk unsteadily;
• Deformity: The affected body part is deformed, or shows lumps or bumps;
• Movement: You can’t move an affected joint;
• Circulation: Your skin over the affected area feels numb or looks pale;
• Bruising and swelling: You notice more than only mild bruising and swelling.

Where can I find out more?

Visit NHS Choices (http://www.nhs.uk/conditions/sprains/pages/introduction.aspx) or the Choose Well website (www.choosewellmanchester.org.uk/self-care) for further information on how to treat and prevent sprains and strains. Remember that your pharmacist can also help you with assessing and managing your symptoms

Produced by the Self Care Forum (www.selfcareforum.org). Next review due October 2024