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by James Thomas, Friday, 25 May 2018 | Categories: General Health

Tips for Heartburn Sufferers

Many people suffer from the symptoms of heartburn, such as the taste of something bitter in the mouth, a sore throat, a chronic cough and fatigue, and are in desperate need of relief. Heartburn and gastro-oesophageal reflux disease (also referred to simply as GERD), which is more serious, are a problem for millions. Four out of five sufferers will experience such symptoms at night, according to research, with the result being disturbed sleep and an impaired ability to function normally the following day. (1) The good news is that there are ways for heartburn sufferers to find relief from these symptoms, with the use of exercise and some simple diet and lifestyle tips.


There are a number of ways in which heartburn can be prevented by making changes to the food and drink you consume. Limiting the consumption of acidic foods like grapefruit, tomatoes, vinegar and oranges is a good idea, and spicy food such as chillies or pepper should also be avoided, if you have noticed a correlation between their consumption and bouts of heartburn. (2) You should try to avoid lying down for up to three hours after having eaten, as sitting up enables gravity to help food, as well as stomach acid, to drain naturally out of your stomach. Switch to non-fatty food and lean meat, as heartburn can be triggered by greasy foods such as cheeseburgers and chips. 

Those who suffer from GERD can help to avoid triggering symptoms of the condition by reducing the amount of chocolate, citrus, pepper, ketchup, mustard, mint, tomatoes and vinegar that they consume, as well by eating smaller meals in general. Eating too quickly can also cause heartburn, so pause between bites, and do not eat anything less than three hours before bedtime as this can trigger symptoms.


Beverages that should be avoided include alcohol, carbonated drinks and caffeine as they can trigger reflux. Many people love cola drinks, but they are also often connected to GERD symptoms and to reflux, so it might be time to start cutting back. GERD can also be worsened by alcohol as it relaxes the oesophageal sphincter, so you may want to consider going teetotal. (3)


There are also a number of simple changes you can make to your overall lifestyle that could help to relieve the symptoms of heartburn. One good tip is to avoid wearing tight clothes as the likes of tight belts and waistbands can press on the stomach and trigger heartburn. Stress can cause an increase in stomach acids, resulting in the boosting of heartburn symptoms, so it is advisable to take a look at your lifestyle to identify causes of stress, and do your best to remove or minimise them. If you are overweight, then heartburn could be another reason to go on a diet and try to shed some pounds, as excess weight makes it much more likely that stomach acid will be backed up into the oesophagus. 

If you find yourself using antacids several times in any given week then you may be suffering from GERD rather than heartburn, in which case you may require a more aggressive form of treatment. The oesophageal sphincter can be relaxed by nicotine, adding yet another to the list of health reasons why you should stop smoking. (4)


Symptoms are not always triggered by the same foods in everyone, so it is vital to keep track of when you suffer symptoms, in order to identify the foods that are triggers for you. You may even want to keep a diary or log of your heartburn incidents, so that identifying the cause is easier. Some people find they experience heartburn following exercise. If this is the case for you, then you may well need to drink more water, which assists with digestion as well as hydration. You should also wait up to two hours after eating before you exercise. (5) 

One method of avoiding heartburn is to chew gum, which can result in an increase in the amount of saliva your body produces, which in turn acts an effective neutraliser for stomach acids. Reflux can be worsened by certain medications, so it is a good idea to consult your doctor regarding alternatives and have a general discussion as to how to manage reflux.







by James Thomas, Saturday, 07 April 2018 | Categories: General Health

Pain, like many other human experiences, is largely subjective. Depending upon a certain person’s medical history and life story, they may experience a painful incident, such as stubbing their toe or having a migraine, in an entirely different manner to a friend or family member. Because of this, pain can often be difficult to treat.

The good news is that our understanding of how pain works is improving every day. In the past few years, more attention has been drawn to painful conditions that specifically affect women, such as endometriosis; in this article from The New Republic, the writer argues that "Too often, a woman’s pain is not merely met with doubt, but suspicion", and explains the various ways in which women are now fighting back against this prejudice.

In addition to shifts in how we think about pain, we’re also seeing improvements in the field of pain management. Just recently, researchers designed a new compound which successfully treated neuropathic pain in animals.

For pain sufferers, in other words, things look set to improve over the next few years. In the meantime, one of the best ways to stay on top of pain symptoms is to be well informed. If you’d like to know more about pain management, read on for a guide to the various types of pain, and how they can be treated.

Acute Pain vs Chronic Pain 

The most common pain categories are acute and chronic. Acute pain is pain that comes on suddenly and is limited in its duration; chronic pain, by contrast, is more permanent in nature. Acute pain is more likely to be caused by damage to the body, while chronic pain is more likely to be caused by a long-term condition – although it can also arise as a result of injury.

Chronic pain can be resistant to medical treatment, and pain medication is not always sufficient. It’s believed that episodes of "breakthrough pain" are experienced by 70% of people who suffer from chronic pain (1). This is where the sufferer has a flare-up of pain, despite being on regular medication. Because chronic pain can be resistant to medical treatment in this way, it can lead to depression and anxiety, which can in turn worsen the symptoms.

Nociceptive Pain vs Neuropathic Pain

After the categories of acute and chronic, pain is most often categorised by whether it is nociceptive, relating to tissue damage, or neuropathic, relating to nerve damage (2).

Pain from tissue damage is more common than pain from nerve damage. You may experience nociceptive pain from injury to your bones, soft tissue or organs, or as a result of a disease. Pain from tissue damage can be acute or chronic, and is often sharp, throbbing or dull.

Neuropathic pain occurs when the nerves are damaged. People who suffer from neuropathic pain often experience a burning sensation and sensitivity in the affected areas. Other symptoms include pins and needles, difficulty sensing different temperatures, and numbness (3).

With both nociceptive and neuropathic pain, mental and emotional problems such as depression can worsen the pain symptoms. This is sometimes referred to as psychogenic pain.

Conditions that Cause Pain

There are a variety of conditions that can cause chronic pain or repeating episodes of acute pain. These include:

  • Cluster headaches, sudden attacks of pain on one side of the head (usually around the eye)
  • Complex Regional Pain Syndrome, which is usually triggered by an injury and causes severe, ongoing pain in the affected area
  • Slipped disc, where the tissue between two vertebrae pushes out and causes back pain
  • Arthritis, where the joints become inflamed and painful
  • Sickle cell disease, which can cause a sudden episode of pain known as a "pain crisis"
  • Endometriosis, a condition that affects women and causes chronic pain which is particularly acute when menstruating

These are just a few of the conditions that can cause ongoing pain symptoms. If you are suffering from pain and you aren’t sure of the cause, you should make an appointment with your GP as soon as possible.

Treating Pain

As we’ve discussed, pain isn’t always easy to treat. However, there are a huge number of different options available to try. To receive a free online assessment regarding your pain, visit our Pain Management Clinic. We can give advice on treatment options and prescribe a range of safe painkillers.





by James Thomas, Friday, 09 February 2018 | Categories: Womens Health

January 22nd - 28th is Cervical Cancer Prevention Week; a Jo’s Cervical Cancer Trust initiative which this year is focusing on the different ways in which women can take small steps towards reducing their risk. By understanding more about the symptoms of cervical cancer, and its risk factors, Jo’s Trust is hoping to lower cervical cancer rates in the UK through education, knowledge, and simple screening.

What is Cervical Cancer?

Cervical cancer occurs when cancerous cells develop in the cervix, and it’s more common than many people think. In fact, cervical cancer is the 13th most common cancer in women (1), and around 3000 new cases are diagnosed each and every year in the UK (2). Sadly, despite high survival rates – women diagnosed with Stage 1 cervical cancer have an 80-99% 5-year survival rate – 3 women lose their lives to the disease every day (3). Many women don’t realise that they have cervical cancer until a later stage.

Improving Awareness

The Jo’s Trust Cervical Cancer Prevention Week is designed to help women become more aware of the signs and symptoms of the disease. The ultimate aim is to improve awareness of the different ways that women can minimise their risk of developing cancer, and take simple measures to ensure that if they do have the disease, the cancer is diagnosed during the early stages for the highest chance of survival.

Here in the UK, many women are not taking advantage of the available screening methods for cervical cancer. There are a number of screening methods available, but one of the most well known techniques is cervical screening, or the ‘smear’ test. Each year, 5 million women in the UK aged between 25-64 are invited for cervical screening (4), although an estimated 1,250,000 won’t make an appointment (5). These statistics are worrying, as it’s believed that regular smears could prevent 75% of cervical cancer cases.

It’s Time to be Proactive

Cervical Cancer Prevention Week is the perfect time for women to be brave, be proactive, and take control. A good starting point is to learn more about the causes of cervical cancer, and how to reduce risk factors. There are many different aspects that can contribute towards the development of cervical cancer, such as chlamydia, smoking, family history, and the use of oral contraceptives, although 99.7% of cervical cancers are caused by the human papillomavirus infection, or HPV (6), which can affect cells.

HPV isn’t always linked to cervical cancer. In fact, HPV is very common and, in many cases, the body is able to successfully fight off the virus without causing any long lasting damage. However, there are some specific forms of HPV – HPV 16 and HPV 18 – which are present in around 70% of cervical cancer cases (7), suggesting that these are typically ‘high risk’ forms. Fortunately, women can determine if they are considered high risk for these forms of HPV by taking a quick and simple HPV screening test at home.

Sharing Knowledge

The Jo’s Trust campaign is also encouraging women to share their knowledge, and ensure that younger girls are growing up armed with the information they need to help protect themselves from disease. The HPV vaccine is now available on the NHS for free for girls aged between 12 and 18, and protects against 4 different types of HPV: HPV 16 and HPV 18, which are most commonly associated with the development of cervical cancer, along with HPV 6 and HPV 11, which can contribute to genital warts.

Reduce Your Risk

Through small lifestyle changes, such as using condoms and stopping smoking, and through regular screening including quick at-home HPV tests, and NHS cervical screening every 3 years (for women aged 25 - 49) or every 5 years (for women aged 50 - 64), women all across the UK can give themselves the best chance to protect themselves from cancer, or catch the disease early to improve their survival rate.

by James Thomas, Saturday, 06 January 2018 | Categories: Sexual Health

Staying Safe in the Bedroom

Christmas and New Year is a time for revelry and fun, with plenty of food and drink... as well as more private activities. The downside to the increased sexual activity at this time of the year is the corresponding rise in the number of sexually transmitted infections, which then have to be treated in the first few months of the New Year. We are already starting to see an uptick in patients presenting with symptoms of an STI. The most common bacterial sexually transmitted infection encountered by us is chlamydia trachomatis.


Chlamydia is a potentially serious infection that can result in infertility in women, as well as the potentially lethal condition known as ectopic pregnancy, if it is not detected and treated as soon as possible.

Chlamydia will normally take around 14 days to appear in a test result but it can produce a positive result earlier. Any negative result prior to 14 days will need to be repeated at the appropriate juncture.


Not everyone who contracts the chlamydia infection will experience obvious symptoms, and screening tests can be done from self taken vaginal swabs or urine samples. 

If a woman is experiencing urinary symptoms then it is probably a better idea to test for chlamydia with a urine sample, rather than a vaginal swab. Urine samples need to be collected at least two hours after the last time urine was passed to ensure an accurate result. 

Sexually active people below the age of 25 should be tested once a year for the infection or every time they acquire a new sexual partner, or in the event of experiencing any symptoms such as pain during urination, painful sex, abdominal pain, or abnormal discharges or bleeding from the vagina. The rest of us need to be tested when we change sexual partner or experience symptoms.


The good news is that chlamydia can be effectively treated either with a single one gram dose of azithromycin or a twice daily seven day 100 mg course of doxycycline. Both of these treatments come with their own advantages and disadvantages.

Doxycycline should not be used in pregnancy.

Anyone who receives any form of treatment should make sure they are tested again from 6 weeks after treatment commenced, in order to make sure the infection has been cured and to avoid the possibility of false results. 

All recent partners from within the last three months should also be given treatment irrespective of their own chlamydia test results. You and your current partners should be simultaneously treated with antibiotics, while abstaining from sex during treatment, even with a condom. 

Long-term complications from a chlamydia infection are much more likely in people who contract the infection numerous times, so anyone who is infected should take additional precautions in the future, in order to make sure that it does not happen again. The use of condoms is vital, and is the only method to protect against infection – but it is not 100% effective and regular screening is still recommended.

by James Thomas, Friday, 17 November 2017 | Categories: Cialis

The Online Clinic is pleased to announce that we are able to offer a generic version of Cialis at a significantly reduced price.

Tadalafil has been one of the most popular treatments for erectile dysfunction because of its relatively long half-life, allowing men more spontaneity than with other erectile dysfunction treatments. Up until now, we have had to prescribe this medication as Cialis as it was still on patent.

Tadalafil as a generic is only available at the 10 mg and 20 mg (on demand doses). If you are using Cialis as a daily medication then we will still have to prescribe as branded Cialis.

If you are already receiving ED medication from The Online Clinic then you can login to request a review of your treatment. If you have not used us before, you can register below.

Free Online Assessment

Quick and Without Obligation

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