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by James Thomas, Saturday, 07 January 2017 | Categories: General Health

Dentists Unite against Antibiotic Resistance

If there’s one health-related topic that’s been consistently grabbing headlines in recent years it’s antibiotic resistance. Antibiotic resistance is a term referring to bacterial infections that can no longer be treated effectively with existing antibiotics. It’s a huge problem facing modern medicine because simple infections that are currently treated quickly and easily may soon become unmanageable. It’s a particular issue for patients undergoing serious medical treatments such as major surgery, chemotherapy or stem cell transplant; the advent of antibiotic resistance means the simplest of surgeries could become too risky to carry out.

For medical professionals, this growing problem has demanded fresh approaches to the use of antibiotics. Resistance develops through overuse and misuse – not finishing a course of antibiotics, for instance, can lead to small amounts of bacteria surviving and, in response to the specific treatment, developing a resistance.

It’s unsurprising, then, that medical bodies like the Faculty of General Dental Practice (FGDP), the British Dental Association and the Association of Clinical Oral Microbiologists are coming together to raise awareness of antibiotic misuse, and to audit the way dentists manage oral and dental infections.

According to, dental treatments account for 9% of all antibiotic use in the UK. By more rigorously auditing the way in which antibiotics are prescribed for dental issues, it is hoped that we will see a decline in misuse. Bodies like the FGDP currently offer guidance for how antibiotics should be prescribed, however, going forward, British dentists are keen to do more.

One tactic is to spend more time explaining treatments to patients. It’s hoped that, with some more guidance from their dentist, patients who are prescribed antibiotics will start taking them more responsibly.

In essence, it all comes down to education, which is why we’ve pulled together a short guide to common dental issues, and how you can treat them safely – without contributing to the resistance crisis.

Common Dental Problems

A common marker of a dental problem is toothache, which occurs when the tissue at the centre of a tooth becomes inflamed. Because some of the causes of toothache can be fairly serious, it’s important to visit a dentist if the pain doesn’t go away on its own after one or two days – particularly if it is very severe.

Causes of toothache include:

  • Tooth decay, in which acid caused by plaque build-up attacks your teeth leading to cavities, or in worse cases gum disease or abscesses
  • A cracked tooth
  • A broken or loose filling
  • Receding gums, in which the gums shrink away, exposing the more sensitive parts of the tooth
  • Periapical abscess, in which a bacterial infection causes pus to collect at the end of the tooth

Oral pain that is not strictly defined as toothache (because it does not stem from the centre of the tooth) can be caused by:

  • Periodontal abscess, in which a bacterial infection causes pus to collect in the gums
  • Sinusitis
  • Ulcers on the gums
  • Soreness around a tooth about to break through (for adults, this typically happens with wisdom teeth)

Treatments for Dental Pain

You may think that dental discomfort caused by a bacterial infection would be automatically treated with antibiotics; however, this isn’t the case. In fact, antibiotics should typically only be prescribed in emergency situations when the infection is very severe.

Usually, dental issues such as those described above should be tackled with a combination of dental procedures (for abscesses, this can involve a root canal or tooth extraction) and lifestyle changes. The current NHS guidance on dental health recommends the following:

  • Brushing your teeth with fluoride toothpaste for two minutes, at least two times a day
  • Using floss or an interdental brush once a day to clean between teeth and around the gum line
  • Reducing your intake of sugary or starchy foods and drinks
  • Visiting your dentist regularly

More guidance on good dental hygiene can be found at The Oral Health Foundation.

In the case of a severe dental abscess, The Online Clinic can prescribe emergency antibiotics. This is a good option if you cannot get access to your dentist. Click here to visit our online dental clinic and learn more.

by James Thomas, Saturday, 07 January 2017 | Categories: Womens Health

How does HRT affect dementia risk?

Hormone replacement therapy (or HRT) has long been the subject of controversy. First made available in the 1940s, it was created as a means of tackling the unpleasant – and for some women, debilitating – symptoms caused by the menopause.

In the 1990s and 2000s, studies were undertaken to study HRT’s long-term effects. When they found evidence that it could increase a woman’s risk of cancer and heart disease, the reaction was swift. Medical bodies began urging doctors to prescribe it only in its lowest effective doses, and many women stopped taking it altogether.

Today, those three letters still evoke a lot of uncertainty in patients and doctors. Many doctors feel uncomfortable prescribing it; many more menopausal women automatically rule it out as a potential treatment because of the risks it may carry.

In an interesting turn of events though, the studies that caused the initial panic have recently been challenged. According to new research, it now looks like HRT is perfectly safe for menopausal women to use. In fact, the latest studies seem to suggest that hormone replacement therapy could be seriously beneficial to post-menopausal women when it comes to staving off dementia.

The Menopause and Dementia

Earlier this year, it was reported that early menopause as caused by surgical removal of the ovaries is linked to a reduction in memory and thinking skills. The fear is that this could in turn lead to early-onset dementia and Alzheimer’s.

It isn’t understood precisely why the removal of the ovaries might have these worrying effects, but the doctor running the study, Gillian Einstein, believes that this indicates the importance of oestrogen in healthy brain function for women.

One fascinating offshoot of this study is that hormone replacement therapy (which artificially boosts oestrogen levels) could now play a seriously important role in maintaining brain health for post-menopausal women. In fact, this isn’t just speculation – in 2014, researchers at the Stanford University School of Medicine found that, when given to post-menopausal women who were at risk of dementia, HRT actively prevented brain degeneration.

While the sample size used in this study was too small to draw any definitive results, it is interesting to consider this research in conjunction with Dr Einstein’s more recent study. If oestrogen is the key to maintaining a healthy brain after the menopause, then it seems only logical that HRT would be the way forward.

All dementia-fighting powers aside, there are plenty of reasons why HRT would appeal to a menopausal woman living with unpleasant symptoms.

The Benefits of Hormone Replacement Therapy

The menopause is a natural part of ageing, which occurs when a woman’s oestrogen levels begin to decline. This predominantly causes period cessation, but other symptoms include:

  • Hot flushes, which can incorporate heart palpitations, sweating, and skin reddening

  • Night sweats and problems sleeping

  • Vaginal dryness, which can cause pain and discomfort during sex
  • Anxiety and low mood

  • Reduced sex drive
  • Difficulty concentrating

Hormone replacement therapy works by boosting oestrogen levels artificially. In turn it helps to tackle all of the symptoms listed above, as well as osteoporosis (the weakening of the bones), which is more common in post-menopausal women. HRT is usually taken for a few years, after which the doses are gradually reduced and treatment eventually ceased.

Types of HRT

There are many different types of HRT available, and the exact kind you are prescribed will depend upon your medical history, symptoms, and how advanced your menopause is.

Women who have had a hysterectomy (i.e. their womb has been removed) can safely take oestrogen on its own; women who still have their womb will have to take a combination of progesterone and oestrogen.

Cyclical HRT is recommended for women experiencing HRT but still having periods, while continuous combined HRT is recommended for post-menopausal women who are no longer having periods.

HRT treatments also come in a variety of preparations. You can take tablets, use patches that stick onto your skin, apply an oestrogen gel directly to your skin or vagina, or even have an implant fitted that gradually releases hormones into your bloodstream.

To find out more about HRT, or to obtain a safe prescription through The Online Clinic, click here.

by James Thomas, Sunday, 27 November 2016 | Categories: Asthma

According to Asthma UK, there are 5.4 million people living with asthma in the UK, 1.1 million of whom are children. That adds up to 1 in every 11 children, meaning that on average there are three with asthma in every classroom in the country.

At first glance, asthma might not seem like the worst health condition to live with, but the reality can be scary. For adults and children coping with severe asthma, living a normal life can be a daily struggle.

The good news is that asthma medications and the techniques for managing the condition effectively are constantly improving. Recent research from the American Academy of Pediatrics also looks set to make a significant contribution to the health of asthmatic children and adults.

According to the experts, the indoor environment of asthma sufferers’ homes plays a crucial role in respiratory health. In fact, controlling this environment could be as vital to asthma management as the use of medication. This discovery is particularly important for parents of asthmatic children, because air-borne pollutants can disrupt the development of young airways. Children are also more likely to be exposed to irritants and pollutants than adults because they spend more time on the floor.

Keeping your Home Safe

The new guidance recommends that parents with asthmatic children take the following precautions in their home:

  • Reduce your child’s exposure to cigarette smoke
  • Dust and clean regularly to avoid exposure to dust mites
  • Address any mould or damp issues
  • Address any issues with pests or vermin

Ultimately, the best thing you can do for your child is to keep your home very clean, dust-free and regularly vacuumed – particularly the rooms they spend the most time in.

Pets & Asthma

The report also discussed the role that family pets can play in children’s asthma. Animal dander is a common asthma trigger and it’s not always easy to control – even if you have a so-called "hypoallergenic" pet.

Giving up your dog or cat is not necessarily the only option if your child has asthma. This is because animal dander is only a problem if your child has an allergy to it – not all asthma sufferers are automatically allergic.

You’ll be able to tell if your child is allergic by monitoring their symptoms when they are around your pets. When the allergy is severe, a reaction will be instant, causing coughing, wheezing, shortness of breath and sometimes even a rash. When the allergy is only mild, a reaction may take a few days to develop.

For children with only a mild allergy, it may be possible to keep pets as long as they are not allowed into bedrooms or communal living areas. Keeping your pets well groomed and clean is also important, as is regularly cleaning and vacuuming.

For children with a severe allergy, it’s worth getting a definitive allergy test before you consider giving up your pet. It may be that your child is allergic to something else in your home.

Other Management Techniques

Keeping your home clean and safe is very important when it comes to asthma management, but there are other important techniques to keep in mind.

The first is having a written asthma action plan. This is a document which details all the vital information related to your child’s condition. It will include a list of your child’s triggers, medications, and what to do in the event of an asthma attack. To establish a comprehensive asthma action plan for your child you will need to take some time monitoring their condition, and working out what their asthma triggers are.

It’s also crucial to make sure your child is using the correct asthma medication. If they are only using a blue reliever inhaler (usually Ventolin) but experiencing symptoms more than three times a week, then it is likely that will need a preventer inhaler.

However, frequent flare-ups of symptoms could also be a sign of an unidentified trigger in the home – whether it’s cigarette smoke, animal dander, dust mites, food additives or mould. In this situation, an allergy test is recommended.

You can read more about asthma and the various medications available to treat it at The Online Clinic. Click here to view our inhalers and learn more about asthma management.

by James Thomas, Saturday, 05 November 2016 | Categories: General Health

It’s a feeling nearly everyone can relate to; you’ve just eaten a delicious meal at a posh restaurant and when you get home to bed, you find yourself clutching your chest and gulping down water to try and alleviate that horrible burning sensation.

No, you’re not having a heart attack – but heartburn (which is caused by stomach acid leaking into the oesophagus) is certainly an unpleasant thing to experience. And you’d be in the minority if you haven’t been through it at least once in your life. Unfortunately, for some Brits, heartburn is a daily reality, just one symptom of a chronic condition known as gastro-oesophageal reflux disease (or GORD, for short).

In 2011, a Norwegian study found that cases of GORD were on the rise, and suggested a link between this and rising body weights. At the time, the Daily Mail reported on this study, interpreting the results as an indication that obesity caused by a fatty diet is a direct cause of heartburn and acid reflux. As shown here, the NHS dismissed the Daily Mail’s take on the results, as the study did not show a link between diet and symptoms.

In fact, while it is true that obesity puts you at greater risk of GORD the foods that most commonly cause heartburn are not those you might expect. According to the experts at WebMD, some of our favourite healthy foods can be a high risk for triggering an attack of heartburn.

If you find yourself regularly battling with heartburn, it’s worth visiting a doctor, as you may be suffering from GORD and may require medication. If you aren’t diagnosed with GORD, or if it’s only causing moderate symptoms, you should be able to manage the condition at home by making some adjustments to your diet and lifestyle.

Foods to Avoid

There are a number of different foods and drinks that can trigger heartburn and acid reflux:

  • Acidic foods such as citrus fruits or juices, and tomatoes
  • Garlic and onion
  • Spicy food containing lots of pepper and/or chilli
  • Peppermint
  • Alcohol
  • Caffeine
  • Chocolate
  • Carbonated drinks

Though the Daily Mail’s condemnation of a fatty diet was a little slapdash, they weren’t totally wrong – as you’ll read here, foods that are high in fat (avocado, cheese, nuts and steak) can also cause heartburn. This is because high-fat foods cause the stomach to empty more slowly, meaning it is more likely to swell, putting pressure on the muscles that keep it closed and allowing for acid to leak out.

Having said that, it may not be necessary to completely cut out the foods and drinks listed above – particularly the healthier ones. However, eating them in moderation, and not in combination with one another, is advised.

Lifestyle Changes

As well as looking out for foods that can trigger your heartburn, you should avoid eating very large meals – instead, eat several small, light meals over the course of the day, and leave several hours between dining or drinking alcohol and going to bed.

Raising the head of your bed by around 20cm can also help to alleviate symptoms. This is because, for stomach acid to leak into the oesophagus, you have to be lying flat or bending over. Lying at an angle should help prevent this from happening. To raise your bed you should insert blocks underneath the bed – simply propping yourself up with pillows will not work.

Losing weight and quitting smoking are also advised.

Medical Treatment for Heartburn

If you are suffering from persistent heartburn, it may be appropriate to start using medication. There are various types available, ranging from over-the-counter antacids to prescription-only proton-pump inhibitors (PPIs) and H2-receptor antagonists (H2RAs). Antacids neutralise the effects of stomach acid, while PPIs and H2RAs actively reduce the amount of acid produced by your stomach.

In rare cases, surgery may be the most suitable course of action. Most commonly, GORD is resolved through keyhole surgery in which the ring of muscle between the oesophagus and the stomach is tightened. This prevents the leakage of stomach acid.

To find out more about medical treatments for heartburn, consult our dedicated heartburn page.

by James Thomas, Saturday, 15 October 2016 | Categories: General Health

For many people, there’s something irresistible about the idea of a midnight snack or a movie night packed with popcorn and sweet treats. But though we all know indulging in biscuits, brownies and crisps is bad for our health at any time of day, how many of us are aware of the toll these foods can take when they’re eaten after 7pm?

If recent findings are to be believed, then we all need to start making our evening binges a thing of the past. As reported here, the European Society of Cardiology has found that people who eat large meals after 7pm experience dramatic increases of blood pressure overnight.

This is worrying because high blood pressure (also known as hypertension) is associated with all kinds of health issues, including heart disease and stroke. It’s also concerning because most of us consider 7pm an ideal time to eat dinner!

If the research is accurate, and eating late really can cause problems with our blood pressure, then what is the best way to stay healthy? Well, it isn’t as simple as eating dinner at 6.30pm.

Current Guidance for Healthy Eating

According to the NHS, there are several factors that go into a healthy diet. The first recommendation is that men consume 2,500 calories and women 2,000 calories a day. This will differ slightly depending upon your age, fitness, health and weight. However, if you get into the habit of eating significantly more or less than this, you could be putting your health at risk.

The calories you consume should also be nutritious, and not simply made up of sweets and junk food. Your daily diet should include:

  • 5 portions of fruits and vegetables
  • Starchy carbohydrates, preferably wholegrain or high fibre
  • Protein in the form of lean meat, fish, eggs, pulses and/or beans
  • Low fat dairy
  • 6 to 8 glasses of water

Red meat should not be eaten too regularly; however, in small portions it does have health benefits, as it is packed with protein, iron and zinc. If you are eating more than 90g a day you are advised to cut down.

Sugary drinks, chocolate, sweets and snack foods that are oily, fatty or salty are not strictly off-limits. However, they should be restricted; eat this kind of junk food in small portions, and not on a regular basis.

The newest research also suggests that eating at the same time every day is also important. Heart expert Dr Ebru Özpelit advises that we should eat a good breakfast, avoid skipping lunch, and keep our evening meal small, light, and ideally before 7pm.

Avoiding High Blood Pressure

It’s not always easy to avoid developing high blood pressure. This is because it is related to age, genetics and family history, and even sleep deprivation.

If you think you may be at risk of high blood pressure, you should visit your doctor for a blood pressure test. A normal blood pressure measurement is anything between 90/60mmHg and 120/80mmHg. High blood pressure is considered anything over 140/90mmHg. However blood pressure between 120/80mmHg and 140/90mmHg is considered prehypertension – this means your blood pressure could continue to rise and pose a risk to your health. If your blood pressure is in this range, you may wish to start making some changes to your diet and lifestyle.

Things you can do to limit your risk of (or lower existing) high blood pressure include:

  • Eating less than 6g of salt a day (roughly one teaspoon)
  • Cutting down your alcohol intake, and avoiding alcohol "binges"
  • Losing weight
  • Exercising (the NHS recommends at least 150 minutes of moderate activity every week)
  • Cutting down on caffeine
  • Quitting smoking
  • Getting a good night’s sleep

In some cases, this won’t be sufficient, and medication will be required.

Medical Treatments for High Blood Pressure

There are several different treatments for high blood pressure. The five most common are:

These medications are prescribed depending upon your age, health and family history. Find out more about pursuing a healthy lifestyle and avoiding high blood pressure by visiting The Online Clinic’s hypertension information page.

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