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by James Thomas, Thursday, 16 November 2017 | Categories: General Health

Antibiotics: Mixed Messages for Patients

Scientific discoveries are happening all the time, and sometimes a new piece of research will come along to dispel everything we thought we knew.

The most recent debate to crop up regards antibiotic resistance. All approved guidance currently relating to antibiotic use tells us that finishing a course of antibiotics is vital, even if we begin to feel better within a couple of days. Now, experts have begun to argue something very different.

A team of UK researchers published a short opinion piece in the BMJ (formerly the British Medical Journal) in July, claiming that there is not enough evidence to suggest that cutting short a course of antibiotics contributes to antibiotic resistance.

One of the researchers, Professor Martin Llewelyn, suggested that long courses were "outdated" and that there is now plenty of evidence that short courses of three to five days work just as well. In his opinion, antibiotics should be prescribed on a case by case basis, tailored towards each patient and their specific infection, and not simply administered in the same way every single time.

While these researchers are not putting forward the idea that patients be allowed to judge themselves when they stop a course, there is concern amongst the medical community that this sort of guidance could end up causing confusion.

Not enough research has been done into the "stop when you feel better" model of antibiotic use, and for that reason Public Health England has recommended that patients continue to follow the advice of their prescribing doctor.

Correct Antibiotic Use

As well as taking the full course of antibiotics that you have been prescribed (whether or not you begin to feel better before the end of the course), there are a few things you can bear in mind if you wish to avoid contributing to antibiotic resistance.

The first thing to know is that antibiotics are only an appropriate treatment in the case of a bacterial infection. They have no effect upon viral infections. The common cold and flu are two types of viral infection, which cannot be treated with antibiotics. 

If you become unwell with a cold, you may be tempted to visit your doctor and ask for antibiotics, but it is always best to wait the infection out, resting at home and taking over-the-counter cold treatments. You should typically only visit your GP if your cold has not cleared after three weeks, or if the symptoms are getting noticeably worse.

The flu tends to be more serious, and you should visit your doctor if you fall into a certain at-risk group such as being over 65 or pregnant. Bear in mind, however, that antibiotics are not an appropriate treatment for the flu, and that the best way to avoid it if you are in an at-risk group is to get the annual flu jab.

Avoiding Infection

If you want to avoid taking antibiotics, one of the best things you can do is to protect yourself against bacterial infections. You can prevent germs from spreading by following the kinds of hygiene tips set out by the NHS here.

Another way to avoid infection is to always practise safe sex. Many STIs are bacterial, which means they should be treated with antibiotics. The problem is that STIs such as gonorrhoea have begun to develop antibiotic-resistant strains, which can be very difficult to treat.

To avoid STIs, you should always:

  • Use condoms during penetrative sex when you aren’t sure your partner is free from infection
  • Use dental dams and condoms during oral sex
  • Avoid sharing sex toys unless they have been cleaned or covered in a new condom

You can read more about the risks associated with specific sexual activities here.

Remember that it’s important to get tested regularly if you’re engaging in any risky sexual behaviours. Getting diagnosed early makes treatment easier and reduces the risk of complications; it will also stop you from passing the infection on to others.




by James Thomas, Saturday, 08 July 2017 | Categories: General Health

In 2017, vegetarianism and veganism are more popular than they have ever been. And yet, for those of us who still eat meat, there’s not much that a vegan campaigner could say to deter us from sinking our teeth into a juicy burger or our Sunday roast beef – until, that is, they start talking about the health risks.

We all know that eating too much red meat is not good for us, largely because it increases our risk of bowel cancer. Now, though, it seems that red meat could be worth avoiding for another health reason altogether: diverticulitis.

Diverticulitis is a condition affecting the colon, also known as the large intestine. It begins with diverticular disease, in which small bulges and pockets develop in the lining of the colon. Diverticulitis refers to a later stage of the condition, in which these pockets become inflamed or infected.

Diverticulitis Symptoms

The symptoms of diverticulitis include pain in the abdomen, particularly after eating; bloating; and a change in your bowel habits. It can also cause flu-like symptoms, such as a fever, feeling unwell, nausea, and vomiting. Diverticulitis can also lead to some unpleasant complications such as bleeding, urinary problems and the development of an abscess or fistula. In rarer cases, diverticulitis can lead to life-threatening conditions such as intestinal obstruction and peritonitis, both of which can require surgery.

According to research carried out recently, the unpleasant condition described above carries a clear association with the consumption of red meat. To get specific, data collected on 46,461 men between 1986 and 2012 indicated that those in the highest one-fifth for red meat consumption had a 58% increased risk for diverticulitis. Researchers suspect that red meat causes inflammation in the colon, which leads to the development of diverticulitis.

This is concerning because, while it’s common to be aware of the bowel cancer risk associated with eating red meat, many people will never have heard of diverticulitis. As a result they may they putting themselves at risk of developing the condition by eating too much red meat – this is a particular concern for people who fall into the following high-risk categories:

  • People who smoke
  • Being obese or overweight
  • Frequent use of anti-inflammatories such as ibuprofen
  • Having a history of constipation
  • Having a family member with diverticular disease

It’s also thought that diverticular disease and diverticulitis are associated with not eating enough fibre.

The good news is that there are some steps you can take to help protect yourself from developing diverticulitis – and they don’t just revolve around cutting out red meat.

Preventing Diverticulitis

The first piece of advice that many doctors will give to someone with diverticular disease is to increase fibre intake. You can increase your fibre intake by consuming more fruits and vegetables, and eating starchy foods such as wholegrain bread, and brown pasta and rice. Pulses and beans are a particularly good source of fibre, as are nuts.

Other preventative measures include quitting smoking, losing weight and exercising more. Going by the study mentioned above, it’s also a good idea to limit your consumption of red meat – the NHS recommends that you should eat no more than 70g of red meat and processed meat a day. As explained by The Telegraph here, that equates to just under 500g of red meat and processed meat a week, which means that, over the course of seven days, you could eat one steak, one pork chop, two pork sausages and a portion of Bolognese sauce.

Treating Diverticulitis

If you do develop diverticulitis, it may be that it can be treated safely at home with a course of antibiotics. During this time you may be advised to stick to a liquids-only and later a low-fibre diet, to avoid putting too much strain on your colon. Once the diverticulitis has been treated, you will likely be advised to adopt a high fibre diet. It can also be helpful to lose weight, quit smoking and start exercising more.

If the condition is more serious, you may require hospital treatment and even surgery. You can read more about these treatments via the NHS.

Find out more about diverticulitis at our diverticulitis page.




by James Thomas, Thursday, 06 July 2017 | Categories: Eyes | General Health

Surfers and swimmers may be at a heightened risk of developing gastroenteritis due to the amount of sewage, laden with bacteria, entering the sea, according to new research. 

Activities such as diving and kayaking that bring people into contact with the sea can also increase the chances of developing a number of other illnesses. These include infection of the ears, eyes, throat and nose, as well as stomach aches, scientists are claiming. The University of Exeter’s Dr Anne Leonard, who is carrying out additional research covering the risk to bathers in the United Kingdom, says current research indicates that recreational activities in coastal waters are causing an increasing number of illnesses. 

Marine activities may also be increasing the chance of being infected with strains of bacteria that are resistant to antibiotics, like E. coli, which have been detected off the UK coast for the first time in large quantities by scientists. However, more research is required in order to confirm these findings, as, up to now, studies have relied upon symptoms being reported by swimmers themselves, making it uncertain whether they really were infected by these types of bacteria.

The path of the bacteria

Dr William Gaze, also of the University of Exeter, led the antibiotic resistant bacteria study, which has highlighted the extent to which a multitude of different kinds of bacteria are entering the sea. The bacteria arrive in the ocean by being passed into the sewage system via the human digestive tract, eventually entering rivers, and finally the ocean, when heavy rain causes sewers to overflow. Dr Gaze discovered that antibiotic resistant E. coli was being swallowed by swimmers and surfers in enough quantities to cause a genuine exposure risk. This makes it a real possibility that that exposure could result in infection, although that has yet to be confirmed.

A real mouthful

In a typical surfing session, participants tend to swallow about 1/6th of a litre of seawater, and that polluted water could contain up to 750 E.coli bugs that are resistant to antibiotics, according to Dr Gaze. However, there is a much lower risk of infection or exposure in the great majority of bathing waters, which have already been judged as meeting with water quality standards. 

Additional research is being carried out by Gaze’s team in order to learn more about the potential health risks inherent in seawater sports. Gaze admits that very little is really known about the way in which antibiotic resistant bacteria can be spread to humans by the natural environment, or how health could be impacted by exposure to such microbes. Given that millions of people spend time on beaches every year, increasing the risk of resistant E. coli being ingested, there could be an even higher level of exposure to resistant bacteria for all water users. 

Gaze’s team discovered that although just 0.12 percent of all E. coli located in coastal waters (and in rivers connected to beaches) were resistant to the important antibiotics class known as 3GCs, or third generation cephalosporins, that amount of concentration was still high enough to pose a potential exposure risk to those making use of the waters.

The Beach Bum survey

A novel experiment known as the Beach Bum survey has been devised by researchers at Exeter University, in order to learn more about the dangers to human health of ocean bacteria. 

150 body-boarders and surfers, who use the ocean three times every month as a minimum, were recruited and provided with a cotton bud. The participants could then self-perform a rectal swab, and hand the results in for examination. Those results are now being analysed by Dr Anne Leonard, in a bid to see what the swabs reveal about the bacteria content in their guts. It's hoped that this analysis could yield vital information about the level of risk caused by bugs that are resistant to antibiotics in our oceans. 

The study’s recruitment process was led by Andy Cummins from Surfers Against Sewage, a campaign group. Cummins says the aim is to have a clearer idea of the risks of entering the water. The study has now been completed, and the findings are expected to be published before long.




by James Thomas, Thursday, 26 January 2017 | Categories: General Health

Diabetes & Pain Management: New Findings

Many people are familiar with diabetes; they know that there are two different types, that type 2 is related to being overweight, and that the disease is often treated with injections of insulin.

What fewer people are familiar with is the fact that there are many health complications associated with diabetes. Pregnant women are faced with a greater risk of miscarriage and stillbirth, sexual dysfunction can become a problem, and the arteries can narrow, leading to heart disease.

One symptom that can be particularly difficult to live with is nerve damage, which can happen as a result of high blood glucose levels. This nerve damage can lead to peripheral neuropathy, a condition that causes burning or tingling sensations, stabbing pain and muscle weakness in the hands and feet.

New Treatment

For certain sufferers, the neuropathy can become so severe that the slightest pressure on the skin of the hands or feet causes agonising pain. Currently, there are a number of different treatments used to manage diabetic neuropathy. However, following a recent study in Germany, it looks as though a brand new treatment is on its way.

As reported here, researchers have discovered a chemical agent that seems to block the nerve signals that channel pain. Currently, nerve damage cannot be reversed, but the research team involved hopes that this new discovery lets the medical community take a step closer towards resolving neuropathy issues in diabetic patients.

The main advantage of this potential treatment (which has been tested on mice and is now set for human trials) is that it acts directly on nerve receptors in the skin, instead of affecting the body’s central nervous system. For this reason, the researchers hope to steer clear of some of the dangerous side effects associated with other medicines used to treat neuropathy.

It’s still early days for this new treatment; until such a medicine is approved for use, diabetic patients have a number of options available to them when it comes to pain management. Read on to learn more about these treatments.

Good Diabetes Management

The first step in managing neuropathy is keeping your diabetes under control. The worse the management of your diabetes, the more likely you are to develop nerve damage.

Lifestyle changes associated with diabetes management involve losing weight, taking more exercise and eating a healthy diet. However, it’s also important to make sure you are using any prescription medication correctly. If you feel that your diabetes might be out of control, you should speak to your doctor.

Pain Relief Medication

Several different types of medication can be prescribed to treat neuropathy. The most common are:

  • amitriptyline (also used for headaches and depression)
  • duloxetine (also used for bladder issues and depression)
  • pregabalin and gabapentin (also used for epilepsy, headaches and anxiety)

If you do not respond to these medications, your doctor may prescribe a strong painkiller like tramadol. Because this medicine can become addictive, it is normally only prescribed for a short period – usually it will be used to treat bouts of particularly bad neuropathic pain, and not on a regular basis.

Topical Treatments

Topical treatments are ones applied directly to the skin, and are a good option for people who experience pain in specific areas, or who do not want/cannot take the medications listed above. Two common topical treatments for neuropathy are:

  • capsaicin cream (rubbed directly into the painful area)
  • a lidocaine plaster (applied to the painful area)

Capsaicin cream contains the chemical that gives chilli peppers their spicy heat. When applied to the skin it is an effective form of pain relief; it's thought to work by blocking pain signals to the brain.

A lidocaine plaster contains local anaesthetic, and when stuck onto the painful area of skin, works to numb that pain.

Finding the Right Treatment for You

The main thing to bear in mind when treating diabetic neuropathy is that everyone is different. It may take you some time to find the right treatment for your pain. However, you shouldn’t lose hope – there are many options out there and, as evidenced by the latest research, new developments are cropping up all the time.

To read more about pain relief, click here and visit The Online Clinic’s Pain Management page.




by James Thomas, Thursday, 26 January 2017 | Categories: General Health

Heartburn and Stroke Risk: Latest Research

Heartburn is something almost everybody can relate to, and more often than not it’s thought of as a minor annoyance, the kind of thing that might – at worst – sour a dinner party.

What many people don’t realise is that, for some sufferers, heartburn can make normal, everyday tasks a real challenge. Regular heartburn is often an indicator of a more serious condition called gastro-oesophageal reflux disease (GORD), which is often associated with other unpleasant symptoms such as acid reflux, bad breath, nausea and difficulty swallowing.

Sometimes heartburn and GORD can be managed through self-care and taking over-the-counter medication. In more extreme cases, prescription medicines are required. Currently the most popular of these is the proton pump inhibitor (PPI), a type of medicine that reduces the amount of acid produced by the stomach.

New Study

However, it now looks as though PPIs may not be as safe to use as previously thought. A recent study by the Danish Heart Foundation has found that PPIs seems to be associated with the risk of stroke. Drawing on fifteen years of records, researchers looked at the number of ischaemic strokes occurring in people who had undergone gastric endoscopy (a technique used to diagnose GORD).

The researchers found that 9,500 of these patients had suffered an ischaemic stroke. They also found that – even when adjusted for contributing factors such as age and medical history – this seemed to bear a relationship to their use of PPIs.

The conclusion drawn was that low daily doses (e.g. 10mg) of proton pump inhibitors are safe; however, the stroke risk seems to creep up at around the 60mg mark.

This may be very concerning for people currently taking proton pump inhibitors, but it’s important to recognise that – as stated – low doses seem to pose no threat, and that there are alternative medications available. If you’re very concerned, speak to your GP. Otherwise, read on to find out more about heartburn and GORD.

What is the difference between heartburn and GORD?

Heartburn normally happens after eating, when acid from the stomach leaks into the oesophagus and causes an unpleasant burning sensation in the chest. Heartburn is often caused by consuming spicy or fatty foods, or drinks containing alcohol or caffeine (it can also be triggered by chocolate, tomatoes and citrus fruit).

In some cases, however, heartburn is a symptom of gastro-oesophageal reflux disease. GORD is different to heartburn because it is a chronic (i.e. long-term) condition, which causes regular symptoms. It's caused by stomach acid leaking into the oesophagus, usually because the muscle at the base of the oesophagus has been weakened.

What are the risk factors for heartburn and GORD?

There are several factors that can put you at risk for heartburn and GORD. These include:

  • being overweight or obese
  • being a smoker
  • pregnancy
  • stress
  • medical conditions such as hiatus hernia or gastroparesis

There is also some evidence to suggest that GORD can be inherited genetically.

Treatments for Heartburn and GORD

If your heartburn isn’t too serious and you think you can manage it without medication, try the following:

  • avoid eating three large meals a day; aim for smaller, more frequent portions over the course of the day
  • work out what triggers your heartburn and avoid it
  • don’t wear clothing that is tight on your stomach
  • raise up the head of your bed so that you sleep at a slight angle; this will help to prevent stomach acid from leaking upwards
  • if you’re stressed, start doing relaxation techniques
  • maintain a healthy weight
  • stop smoking

If you can’t manage your symptoms on your own, visit a pharmacy for over-the-counter medication such as antacids. If the condition is more serious, you can request prescription medication from your doctor.

The prescription treatments for heartburn and GORD are:

  • Proton pump inhibitors
  • H2-receptor antagonists

If you are prescribed either of these, you will be given the lowest dose to begin with; this means that for many patients, PPIs should still be safe to use. To read more, visit The Online Clinic’s Heartburn page.

In some situations, surgery may be appropriate. Click here to find out more about your surgical options for heartburn and GORD.




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