Ewing sarcoma
of cancer, cancer types in adults

The 3 main types of primary bone cancer are chondrosarcoma, osteosarcoma and Ewing sarcoma.

Ewing sarcoma most commonly affects people who are 10 to 20 years old.


Ewing sarcoma most commonly affects people who are 10 to 20 years old.

Symptoms

The symptoms of Ewing sarcoma will depend on the size of the cancer and where it is in the body.

The main symptoms are pain in the affected area that gets progressively worse, and swelling and tenderness.

Other possible, but less common, symptoms may include a high temperature (fever), severe tiredness and weight loss.

In some cases of Ewing sarcoma, there may not be any symptoms at all. However, as the tumour grows it could weaken the affected bone, increasing the risk of fracture.

Causes

Like other types of bone cancer, the exact cause of Ewing sarcoma is unknown.

As the condition tends to predominantly affect older children and teenagers, one theory is that it may be related to fast-growing bones.

The rapid growth spurt that happens during puberty may in some way make bone tissue more vulnerable to cancer.

Research has also found babies born with an umbilical hernia are 3 times more likely to develop Ewing sarcoma. 

However, the increased risk is still small as only 1 in 110,000 children with an umbilical hernia will go on to develop the condition.

The Cancer Research UK website has more information about the risks and causes of bone cancer.

Diagnoses

When you visit your GP because of bone pain, they’ll ask you about your symptoms and examine the affected area.

Your GP may refer you for an X-ray to check for anything abnormal. If abnormalities are found, you’ll be referred to an orthopaedic surgeon (a bone specialist).

They may recommend that you have a magnetic resonance imaging (MRI) scan to examine the area in closer detail.

A bone biopsy may be carried out to confirm whether cancer is present. A fine needle is used to remove a sample of bone marrow from the affected area so it can be examined under a microscope. It can either be carried out using a general anaesthetic or a local anaesthetic.

The Cancer Research UK website has more information about tests for bone cancer and the stages of bone cancer.

Treatments

Like all types of cancer, the earlier Ewing sarcoma is diagnosed, the easier it is to treat.

Ewing sarcoma is usually treated with a combination of chemotherapy, surgery and radiotherapy.

Chemotherapy may be used before surgery to shrink the tumour and make it easier to remove.

Ewing sarcoma also responds well to radiotherapy. It can be used to shrink the tumour after chemotherapy, and before or after surgery to lower the risk of the cancer returning.

In some cases, surgically removing Ewing’s sarcoma can be difficult – for example, if it develops in the pelvis. In this case, radiotherapy may be used as the main treatment.

Surgery

If surgery is recommended, the type you’ll have will depend on:

the size of the tumour where it is in your body whether it has grown into the tissues surrounding the bone

You may have surgery to remove part or all of the bone affected by cancer. This type of surgery is known as resection.

Limb-sparing surgery involves removing the area of bone on an arm or leg where the cancer is growing. A piece of metal (prosthesis) or a bone graft will be used to replace the piece of bone that is removed.

In some cases, your whole arm or leg may need to be removed (amputation). This may be the only option to prevent the cancer returning if it’s spread into the tissues surrounding the bone.

For more information about the types of treatment for bone cancer, visit the Cancer Research UK website.

Ewing sarcoma: Children
of cancer, cancer types in children

More children than ever are surviving childhood cancer. There are now new and better drugs and treatments, and we can now also work to reduce the after-effects of having had cancer in the past.

It’s devastating to hear that your child has cancer. At times it can feel overwhelming but there are many healthcare professionals and support organisations to help you through this difficult time.

Understanding more about the cancer your child has, and the treatments that may be used, can often help parents to cope. Your child’s specialist will give you more detailed information and if you have any questions it’s important to ask the specialist doctor or nurse who knows your child’s individual situation.


It’s devastating to hear that your child has cancer. At times it can feel overwhelming but there are many healthcare professionals and support organisations to help you through this difficult time.

Understanding more about the cancer your child has, and the treatments that may be used, can often help parents to cope. Your child’s specialist will give you more detailed information and if you have any questions it’s important to ask the specialist doctor or nurse who knows your child’s individual situation.


Understanding more about the cancer your child has, and the treatments that may be used, can often help parents to cope. Your child’s specialist will give you more detailed information and if you have any questions it’s important to ask the specialist doctor or nurse who knows your child’s individual situation.

Symptoms

Pain is the most common symptom of bone cancer. It is frequently worse at night. However, symptoms may vary depending on the position and size of the cancer. There may be some swelling in the affected area if the tumour is close to the surface of the body and it may become tender to touch. This may cause a limp if in the leg or pelvis. Bone cancer is sometimes discovered when a bone that has been weakened by cancer breaks after the child has a minor fall or accident. Occasionally, there may be fever or weight loss.

Causes

The exact causes of primary bone cancer are unknown. The development of Ewing sarcoma may be related in some way to times of rapid bone growth, which may explain why more cases are seen in teenagers. Like other cancers, it’s not infectious and cannot be passed on to other people.

Diagnoses

Usually you begin by seeing your GP, who will examine your child and may arrange tests or X-rays. If a sarcoma is suspected, your GP should refer your child directly to a specialist hospital or bone tumour centre. A variety of tests and investigations are needed to diagnose Ewing sarcoma, including an X-ray of the painful part of the bone, a chest X-ray and a blood test. A specialist doctor will remove a small piece of the tumour to look at under a microscope (biopsy). Other tests may be done, such as a bone scan, PET scan, a bone marrow biopsy. An MRI or CT scan may also be done.

Any tests and investigations that your child needs will be explained to you.

Treatments

A combination of various treatments is used to treat Ewing sarcoma. These include chemotherapy, surgery and radiotherapy. Treatment will depend on a number of factors, including the size and position of the tumour.

Chemotherapy

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells.

This is a very important component of treatment for the majority of children with Ewing sarcoma and can help make surgery more straightforward. A combination of different chemotherapy drugs are given before surgery and continued afterwards in order to destroy any remaining cancer cells and prevent the sarcoma from spreading. Chemotherapy given in this way is called adjuvant chemotherapy.

Surgery

If surgery is needed, it should be carried out at a specialist orthopaedic bone tumour centre. The aim of surgery is to remove the tumour without causing too much damage. If the tumour is in one of the main bones of the arm or leg, it may be necessary to remove the whole limb (amputation) or part of the affected bone. If only part of the affected bone is removed, this is known as limb-sparing surgery.

Amputation

Sometimes amputation of the limb is unavoidable if the cancer has affected the surrounding blood vessels and nerves. After amputation, a false limb will be fitted, and this will be regularly adjusted as your child grows. False limbs work very well. It should be possible for your child to join in with normal activities and even sport.

Limb-sparing surgery

There are several ways in which limb-sparing surgery may be done. It may involve:

replacing the bone with a prosthesis (a specially designed artificial part) replacing the bone with bone taken from another part of the body (a bone graft)

After limb-sparing surgery, the child is often able to use the limb almost normally. However, it is best not to take part in any contact sports, because any damage to the bone graft or prosthesis may require another major operation to repair or replace it. If the child is growing, the limb prosthesis will need to be lengthened from time to time as the bone grows. This may mean further short stays in hospital, although some prostheses can be lengthened during an outpatient procedure.

Radiotherapy

Radiotherapy treats cancer by using high energy rays that destroy cancer cells while doing as little harm as possible to normal cells. Ewing sarcoma responds very well to radiotherapy. It’s often used after chemotherapy and before or after surgery. If the tumour is impossible to remove surgically, it’s a good option.

Side effects of treatment for Ewing sarcoma

Treatment often causes side effects. Your child’s doctor will discuss this with you before the treatment starts. Any possible side effects will depend on the actual treatment being used and the part of the body that’s being treated.

Side effects can include:

feeling sick (nausea) and being sick (vomiting) hair loss increased risk of infection bruising and bleeding tiredness diarrhoea

Radiotherapy can cause irritation or soreness of the skin in the area being treated and general tiredness. If your child is having surgery, the surgeon will explain the possible complications of the surgery that your child is having.

Late side effects

A small number of children may develop other side effects, sometimes many years later. These include a reduction in normal bone growth, reduced fertility, a change in heart function, and a small increase in the risk of developing a second cancer later in life. Your child’s doctor or nurse will explain all of this to you and will monitor your child carefully for any potential late side effects.

Clinical trials

Many children have their treatment as part of a clinical research trial. Trials aim to improve our understanding of the best way to treat an illness, usually by comparing the standard treatment with a new or modified version. Specialist doctors carry out trials for children’s cancers. If appropriate, your child’s medical team will talk to you about taking part in a clinical trial, and will answer any questions you have. Written information will be provided to help explain things.

Treatment guidelines

Sometimes, clinical trials are not available for your child’s tumour. This may be because a recent trial has just finished, or because the tumour is very rare. In these cases, you can expect your doctors and nurses to offer treatment which is agreed to be the most appropriate, using guidelines which have been prepared by experts across the country. The Children’s Cancer and Leukaemia Group (CCLG) is an important organisation which helps to produce these guidelines.

Follow-up care

Your child will have regular follow-up appointments, with x-rays or scans as necessary. Many children with Ewing sarcoma can be cured. Even if the tumour comes back, further treatment may be given successfully. Your child will be checked up on every few months for the first 3 years after treatment and then every 6 months for another 2 years.

If you have specific concerns about your child’s condition and treatment, it’s best to discuss them with your child’s doctor who knows the situation in detail.

Your feelings

As a parent, the fact that your child has cancer is one of the worst situations you can be faced with. You may have many emotions, such as fear, guilt, sadness, anger and uncertainty. These are all normal reactions and are part of the process that many parents go through at such a difficult time. It’s not possible to address here all of the feelings you may have. However, the CCLG booklet Children & Young People’s Cancer; A Parent’s Guide talks about the emotional impact of caring for a child with cancer and suggests sources of help and support.

Your child may have a variety of powerful emotions throughout their experience with cancer. The Parent’s Guide discusses these further and talks about how you can support your child.

Eye cancer
of cancer, cancer types in adults

eye melanoma squamous cell carcinoma lymphoma retinoblastoma – a childhood cancer

Cancer can also sometimes develop in the tissues surrounding your eyeball or spread to the eye from other parts of the body, such as the lungs or breasts.

This topic focuses on melanoma of the eye, one of the most common types of eye cancer. 


This topic focuses on melanoma of the eye, one of the most common types of eye cancer. 

Symptoms

Eye cancer doesn’t always cause obvious symptoms and may only be picked up during a routine eye test.

Symptoms of eye cancer can include:

shadows, flashes of light, or wiggly lines in your vision blurred vision a dark patch in your eye that’s getting bigger partial or total loss of vision bulging of one eye a lump on your eyelid or in your eye that’s increasing in size pain in or around your eye, although this is rare

These symptoms can also be caused by more minor eye conditions, so they’re not necessarily a sign of cancer. However, it’s important to get the symptoms checked by a doctor as soon as possible.

Causes

Eye melanoma occurs when the pigment-producing cells in the eyes divide and multiply too rapidly. This produces a lump of tissue known as a tumour.

It’s not clear exactly why this occurs, but the following factors may increase the risk of it happening:

lighter eye colour – if you have blue, grey or green eyes, you have a higher risk of developing eye melanoma compared with people who have brown eyes white or pale skin – eye melanoma mostly affects white people and is more common in those with fair skin unusual moles – if you have irregularly shaped or unusually coloured moles, you’re more at risk of developing skin cancer and eye melanoma use of sunbeds – there’s some evidence to suggest that exposing yourself to ultraviolet (UV) radiation from sunbeds, for example, can increase your risk of eye melanoma overexposure to sunlight – this increases your risk of skin cancer, and may also be a risk factor for eye melanoma

The risk of developing eye melanoma also increases with age, with most cases being diagnosed in people in their fifties.

Diagnoses

If your GP or optician (optometrist) suspects you have a serious problem with your eyes, they will refer you to a specialist eye doctor called an ophthalmologist for an assessment.

If they suspect you have melanoma of the eye, they’ll refer you to a specialist centre for eye cancer. There are 4 centres in the UK, located in London, Sheffield, Liverpool, and Glasgow.

It’s likely you’ll have a number of different tests at the centre, including:

an eye examination – to look at the structures of your eyes in more detail and check for abnormalities an ultrasound scan of your eye – a small probe placed over your closed eye uses high-frequency sound waves to create an image of the inside of your eye; this allows your doctor to find out more about the position of the tumour and its size a fluorescein angiogram – where photographs of the suspected cancer are taken using a special camera after dye has been injected into your bloodstream to highlight the tumour

Occasionally, a thin needle may be used to remove a small sample of cells from the tumour (biopsy). The genetic information in these cells is analysed to give an indication of the chances of the cancer spreading or coming back.

Treatments

Treatment for melanoma of the eye depends on the size and location of the tumour. Your care team will explain each treatment option in detail, including the benefits and any potential complications.

Treatment will aim to conserve the affected eye whenever possible.

The main treatments for eye melanoma are:

brachytherapy – tiny plates lined with radioactive material called plaques are inserted near the tumour and left in place for up to a week to kill the cancerous cells external radiotherapy – a machine is used to carefully aim beams of radiation at the tumour to kill the cancerous cells surgery to remove the tumour or part of the eye – this may be possible if the tumour is small and you still have some vision in your eye removal of the eye (enucleation) – this may be necessary if the tumour is large or you’ve lost your vision; the eye will eventually be replaced with an artificial eye that matches your other eye

Chemotherapy is rarely used for eye melanoma, but may be suitable for other types of eye cancer.

The Cancer Research UK website has more information about the treatment options for eye cancer and the types of eye cancer surgery.

Febrile seizures
of brain nerves and spinal cord

A febrile seizure is a fit that can happen when a child has a fever.

Febrile seizures are also sometimes called febrile convulsions. They are relatively common and, in most cases, aren’t serious.

Around one in 20 children will have at least one febrile seizure at some point. They most often occur between the ages of six months and three years.

During a febrile seizure, the child’s body usually becomes stiff, they lose consciousness and their arms and legs twitch. Some children may wet themselves. This is known as a tonic clonic seizure.

Read more about the symptoms of febrile seizures

Symptoms

The main symptom of a febrile seizure is a fit that occurs while a child has a fever.

Febrile seizures often occur during the first day of a fever, which is defined as a high temperature of 38C (100.4F) or above. 

However, there appears to be no connection between the extent of your child’s fever and the start of a seizure. Seizures can occur even if your child has a mild fever.

Simple febrile seizures can happen when there’s a rapid rise in temperature and you may only realise your child is ill when they have a fit. Alternatively, they can occur as your child’s temperature drops from a high level.

During simple febrile seizures:

your child’s body will become stiff and their arms and legs will begin to twitch they’ll lose consciousness and they may wet or soil themselves they may also vomit and foam at the mouth and their eyes may roll back the seizure usually lasts for less than five minutes following the seizure, your child may be sleepy for up to an hour afterwards

Complex febrile seizures tend to last longer than 15 minutes, and the symptoms may only affect one area of your child’s body. The seizure sometimes recurs within 24 hours or during the period in which your child is ill.

Causes

The cause of febrile seizures is unknown, although they’re linked to the start of a fever (a high temperature of 38C (100.4F) or above).

In most cases, a high temperature is caused by an infection such as:

chickenpox flu (influenza) middle ear infections (otitis media) tonsillitis

There may also be a genetic link to febrile seizures because the chances of having a seizure are increased if a close family member has a history of them. Around one in four children affected by febrile seizures has a family history of the condition.

Read more about the causes of febrile seizures


Febrile seizures are linked to fevers, but the exact cause is unknown.

Some researchers think that the biological processes associated with a high temperature may be responsible.

A high temperature is thought to be caused by a bacterial or viral infection that stimulates the release of cytokines. Cytokines are proteins that affect the parts of the brain and nervous system responsible for regulating the body’s temperature. Their release causes a rise in the body’s temperature.

One theory is that in certain people, high levels of cytokines may temporarily ‘scramble’ the workings of the brain and nervous system, triggering a seizure.

Diagnoses

Febrile seizures can often be diagnosed from a description of what happened.

Further tests may be needed if the cause of the associated infection isn’t clear.

It’s unlikely that your doctor will see the seizure, so an account of what happened is useful.

It’s useful to know:

how long the seizure lasted what happened – body stiffening, twitching of the face, arms and legs, staring and loss of consciousness whether your child recovered within one hour whether they’ve had a seizure before

Tests to identify the source of the infection will only usually be necessary to rule out rarer conditions which can cause similar symptoms, such as meningitis.

A blood or urine sample may be needed to test for signs of infection. It can sometimes be difficult to obtain a urine sample from young children, so it may have to be done in hospital.

Read more about blood tests


Further tests may be carried out in hospital if your child’s symptoms are unusual – for example, if they don’t have a high temperature or their seizures don’t follow the normal pattern.

Further testing and observation in hospital is also usually recommended if your child is having complex febrile seizures.

Your child may have other tests including an electroencephalogram and lumbar puncture, particularly if they’re less than 12 months old.

These two tests are explained below.

Electroencephalogram

An electroencephalogram (EEG) measures your child’s electrical brain activity through electrodes that are placed on their scalp. Unusual patterns of brain activity can sometimes indicate epilepsy.

However, some studies have suggested that an EEG may not be useful in many cases of febrile seizures.

Lumbar puncture

During a lumbar puncture, a small sample of cerebrospinal fluid (CSF) is removed for testing. CSF is a clear fluid that surrounds and protects the brain and spinal cord.

A hollow needle is inserted into the base of the spine to obtain the CSF sample. During the procedure, local anaesthetic will be used to numb your child’s back so that they don’t feel any pain.

A lumbar puncture can be used to determine whether your child has an infection of the brain or nervous system.

Treatments

In many cases, febrile seizures do not need to be treated, although care should be taken to deal with a seizure as it happens.

Complications

Febrile seizures have been linked to an increased risk of epilepsy, as well as other problems.

Recent research findings may indicate a link between febrile seizures and sudden unexplained death in childhood (SUDC), possibly due to the connection between febrile seizures and epilepsy.

However, this link hasn’t been proven and SUDC is incredibly rare, affecting around one in 100,000 children which is equivalent to a 0.001% chance.

In addition, one of the biggest studies of its kind looked at more than 1.5 million children with a history of febrile seizures and found no evidence of an increased risk of death in later childhood or adulthood.

Febrile seizures and epilepsy

Many parents worry that if their child has one or more febrile seizures, they’ll develop epilepsy when they get older. Epilepsy is a condition where a person has repeated seizures without fever.

While it’s true that children who have a history of febrile seizures have an increased risk of developing epilepsy, it should be stressed that the risk is still small.

It’s estimated that children with a history of simple febrile seizures have a one in 50 chance of developing epilepsy in later life. Children with a history of complex febrile seizures have a one in 20 chance of developing epilepsy in later life.

This is compared to around a one in 100 chance for people who haven’t had febrile seizures.

Feeling of something in your throat (Globus)
of ears nose and throat

Globus can be caused by many things, such as an increased tension of muscles or irritation in the throat.

There are various things you can do to manage your globus symptoms at home, without the need to attend your GP.


There are various things you can do to manage your globus symptoms at home, without the need to attend your GP.

Symptoms

Different people describe it differently. It may be felt as:

tightness or a pressure in your throat catarrh/mucus that you are unable to clear an area of discomfort in your throat a feeling of something stuck or a lump in your throat

If you feel something sticking in your throat, but can eat and drink normally and without pain, you do not need to worry. Many people with globus sensation notice the symptoms most when they are swallowing their saliva, or that it increases with stress and worry. Your symptoms can vary from day to day.

Treatments

There are a number of things you can do to try to relieve globus symptoms.

Eating and drinking

Try to drink at least 1.5 litres (3 pints) of water every day. You should drink in small sips as swallowing helps to relax the throat.

Avoid too much alcohol, tea, coffee and fizzy drinks. They can cause the throat to be dry.

Try to reduce the amount of fatty and spicy food in your diet.

Leave at least 3 hours between your last meal and going to bed. Avoid snacking between your last meal and bedtime.

Consider trying anti-reflux medication (your pharmacist can advise).

Smoking

Smoking causes irritation to your throat. By stopping smoking, you can help to improve your globus symptoms.

Your pharmacist or GP can offer support if you would like advice.

Further information on stopping smoking

Throat clearing

Try not to clear your throat as this can make your globus sensation worse. You can try sipping water, instead.

Losing weight

Losing any excess weight may reduce your symptoms.

Reducing stress

Stress can increase your globus sensation.

If you think you might be stressed, try to relax in a way that is doable for you and your situation. Breathing and relaxation exercises can sometimes help, but if you feel you need further help with managing stress, your GP can discuss this with you.

Further information about relieving stress

In most people, symptoms will get better following these self-help tips. However, for some people symptoms can recur off and on for several months.


There are no specific tests to diagnose globus. Further investigations are not required, so you don’t usually need to see a GP.

Speak to your GP if: you develop any difficulty or pain when swallowing you feel a lump in the neck you experience unintentional weight loss your symptoms do not improve If your symptoms do not improve, your GP will provide further support and advice on whether you need to see an ear nose and throat (ENT) specialist.

Fever in adults
of infections and poisoning

You can find out if you have a fever by using a thermometer to take your temperature.

Symptoms

Causes

A fever is your body’s natural response to many common illnesses such as:

flu tonsillitis kidney or urinary tract infections (UTIs)

Fever helps your body fight infections by stimulating your immune system (your body’s natural defence). By increasing your body’s temperature, a fever makes it harder for the bacteria and viruses that cause infections to survive.

Treatments

Contact your GP practice if: you have severe thirst or are peeing less you are passing urine that is darker than normal you are light-headed or weak you have new, severe muscle cramps your symptoms have worsened or you notice new symptoms you’ve had a fever after recent foreign travel If your GP practice is closed, phone 111.

Contact your GP practice immediately if: You have a fever and you: are on treatment for immune deficiency are on immune-suppressant drugs, such as regular steroids, methotrexate, azathioprine or cyclophosphamide are taking medication where you have been warned about a risk of a reduced immune system are on, or recently completed, treatment for cancer, leukaemia or lymphoma are a transplant recipient are HIV positive have chronic lung disease have asthma which has been treated with medication in the last 3 years have heart disease (excluding blood pressure which is currently well controlled) have diabetes or another metabolic disease have chronic gastrointestinal or liver disease have chronic renal (kidney) disease have cystic fibrosis have neurological conditions such as cerebral palsy, stroke, multiple sclerosis or muscular dystrophy have sickle cell disease

Treating a fever

Most fevers will improve on their own in a few days. However, there are a number of things you can do to help the uncomfortable feelings associated with a fever.

Do wear loose comfortable clothingmake sure the room you are in isn’t too warmdrink more fluids (for example water) so you don’t get dehydrated – you should be peeing approximately every 6 hours (a pale yellow urine means you’re unlikely to be dehydrated)avoid alcohol as this can make dehydration worsetake a medicine that reduces fever such as paracetamol (unless you’re allergic or have been told by a healthcare professional that you can’t take it)

Don’t do not over dressdo not attempt to make yourself feel cold

Fever in children
of infections and poisoning

A quick and easy way to find out whether your child has a fever is to take their temperature using a thermometer.



Common conditions that can cause fevers include:

upper respiratory tract infections (RTIs) flu ear infections roseola – a virus that causes a temperature and a rash  tonsillitis kidney or urinary tract infections (UTIs) common childhood illnesses, such as chickenpox and whooping cough

Your child’s temperature can also be raised after vaccinations, or if they overheat because of too much bedding or clothing.

Symptoms

breathlessness vomiting  rash  fits or seizures 

Possible serious bacterial illnesses include:

meningitis – infection of the meninges, the protective membranes that surround the brain and spinal cord septicaemia – infection of the blood pneumonia – inflammation of the lung tissue, usually caused by an infection

Potentially serious causes of fever are relatively rare.

Causes

Most fevers are caused by infections or other illnesses. The high body temperature makes it more difficult for the bacteria and viruses that cause infections to survive.

Common conditions that can cause fevers include:

upper respiratory tract infections (RTIs) flu ear infections roseola – a virus that causes a temperature and a rash  tonsillitis kidney or urinary tract infections (UTIs) common childhood illnesses, such as chickenpox and whooping cough

Your child’s temperature can also be raised after vaccinations, or if they overheat because of too much bedding or clothing.

Treatments

Phone 999 if your child: has a stiff neck has a rash that does not fade when you press a glass against it (use the ‘glass test’ from Meningitis Now) is bothered by light has a fit (febrile seizure) for the first time (they cannot stop shaking) has unusually cold hands and feet has blue, pale or blotchy skin, lips or tongue has a weak, high-pitched cry that’s not like their normal cry is drowsy and hard to wake is extremely agitated (does not stop crying) or is confused finds it hard to breathe and sucks their stomach in under their ribs is not responding like they normally do, or is not interested in feeding or normal activities

Contact your GP if: Your child: is under 3 months and has a temperature of 38°C (101°F) or above is over 3 months and has a temperature of 39°C (102°F) or above has other signs of illness, such as a rash, as well as a high temperature has a high temperature that’s lasted for 5 days or more has persistent vomiting does not want to eat, or is not their usual self and you’re worried has a high temperature that does not come down with paracetamol is dehydrated – such as nappies that are not very wet, sunken eyes, and no tears when they’re crying If your GP is closed, phone 111. If your child seems to be otherwise well – for example, if they’re playing and attentive – it’s less likely they’re seriously ill.


If your child has a fever, it’s important to keep them hydrated by giving them plenty of cool water to drink.

Babies should be given plenty of liquids, such as breast milk or formula. Even if your child isn’t thirsty, try to get them to drink little and often to keep their fluid levels up.

If it’s warm, you could help your child to stay at a comfortable temperature by covering them with a lightweight sheet or opening a window.

However, they should still be appropriately dressed for their surroundings and sponging your child with cool water isn’t recommended to reduce a fever.

Medicine to reduce fever (antipyretics)

Children’s paracetamol or ibuprofen work as antipyretics, which help to reduce fever, as well as being painkillers. You can’t give them both at the same time, but if one doesn’t work, you may want to try the other later.

Antipyretics aren’t always needed. If your child isn’t distressed by the fever or underlying illness, there’s no need to use antipyretics to reduce a fever.

Always read the patient information leaflet that comes with the medication. This will tell you the correct dose and frequency for your child’s age.

Fibroids
of womens health, girls and young women puberty to around 25, periods and menstrual health

These growths are made up of muscle and tissue and can be different sizes. Some can be the size of a pea, others can be the size of a melon. They’re sometimes known as uterine myomas or leiomyomas.

Fibroids are common. Around 1 in 3 people who menstruate develop them at some point in their life. They’re more common as you get older.


Fibroids are common. Around 1 in 3 people who menstruate develop them at some point in their life. They’re more common as you get older.

Symptoms

Many people don’t know that they have fibroids because they don’t have any symptoms. This is nothing to worry about.

Speak to your doctor if: You’re worried about your symptoms or you regularly have: heavy periods painful periods tummy (abdominal) pain lower back pain a frequent need to urinate constipation pain or discomfort during sex symptoms which are affecting your day to day life

If your doctor thinks you might have fibroids, they’ll usually refer you for an ultrasound scan to confirm the diagnosis.

Causes

The exact cause of fibroids is unknown. They’re linked to the hormones produced by the ovaries, oestrogen and progesterone. Fibroids usually develop and grow as long as the ovaries are producing these hormones. Fibroids may continue to grow during pregnancy. They tend to shrink when these hormone levels fall, such as after the menopause.

Treatments

Fibroids will often shrink after the menopause, as hormone levels in your body change.

If you have fibroids, but you’re not affected by any symptoms then you don’t need treatment.

However, if you do have symptoms, your doctor can recommend the right treatment for you. Treatment options include:

over-the-counter pain relief like ibuprofen the contraceptive pill which can reduce heavy menstrual bleeding medication taken only during your period that can reduce heavy menstrual bleeding medicines that can shrink fibroids by lowering your oestrogen and progesterone levels in rare cases, surgery

Your doctor will discuss these treatments with you and you can ask any questions that you might have.

Fibromyalgia
of muscle bone and joints, conditions

an ache a burning sensation a sharp stabbing pain a mixture of these 3 feelings

The pain is likely to be continuous, but it might be better or more severe at different times.

As well as widespread pain, people with fibromyalgia might also have:

increased sensitivity to sensations like touch, light, temperature, noise fatigue (extreme tiredness) muscle stiffness difficulty sleeping problems with mental processes (known as “fibro-fog”) – like problems with memory and concentration headaches irritable bowel syndrome (IBS) – a digestive condition that causes stomach pain and bloating dizziness and clumsiness feeling too hot or too cold restless legs syndrome tingling, numbness, prickling or burning sensations in your hands and feet (pins and needles, also known as paraesthesia) unusually painful periods (if you get periods) anxiety depression

Speak to your GP or healthcare professional if: you think you might have fibromyalgia


As well as widespread pain, people with fibromyalgia might also have:

increased sensitivity to sensations like touch, light, temperature, noise fatigue (extreme tiredness) muscle stiffness difficulty sleeping problems with mental processes (known as “fibro-fog”) – like problems with memory and concentration headaches irritable bowel syndrome (IBS) – a digestive condition that causes stomach pain and bloating dizziness and clumsiness feeling too hot or too cold restless legs syndrome tingling, numbness, prickling or burning sensations in your hands and feet (pins and needles, also known as paraesthesia) unusually painful periods (if you get periods) anxiety depression

Speak to your GP or healthcare professional if: you think you might have fibromyalgia

Symptoms

The main symptom of fibromyalgia is widespread pain that might feel like:

an ache a burning sensation a sharp stabbing pain a mixture of these 3 feelings

The pain is likely to be continuous, but it might be better or more severe at different times.

As well as widespread pain, people with fibromyalgia might also have:

increased sensitivity to sensations like touch, light, temperature, noise fatigue (extreme tiredness) muscle stiffness difficulty sleeping problems with mental processes (known as “fibro-fog”) – like problems with memory and concentration headaches irritable bowel syndrome (IBS) – a digestive condition that causes stomach pain and bloating dizziness and clumsiness feeling too hot or too cold restless legs syndrome tingling, numbness, prickling or burning sensations in your hands and feet (pins and needles, also known as paraesthesia) unusually painful periods (if you get periods) anxiety depression

Speak to your GP or healthcare professional if: you think you might have fibromyalgia

Causes

It’s not clear why some people develop fibromyalgia. The exact cause is unknown, but it’s likely that many factors are involved.

Altered pain messages

Your brain, nerves and spinal cord make up your central nervous system. Changes in the way your central nervous system sends and receives information to your body might cause fibromyalgia.

Fibromyalgia is a type of chronic pain.

Read more about chronic pain

Genetics

Some people are more likely than others to develop fibromyalgia because of the genes inherited (passed on) from their parents.

Triggers

Fibromyalgia is often triggered by a stressful event. This might be a physically stressful event or an emotionally (psychologically) stressful event.

Possible triggers of fibromyalgia might be:

an injury a viral infection giving birth an operation the breakdown of a relationship being in an abusive relationship the death of a loved one

Sometimes there isn’t an obvious trigger.

Diagnoses

Diagnosing fibromyalgia can be difficult. There’s no specific test to diagnose the condition.

The symptoms of fibromyalgia can vary. The symptoms can be similar to those of several other conditions. Your GP will have to rule out other conditions with similar symptoms.

You’ll be asked about how your symptoms are affecting your daily life. You’ll be examined to check for signs of other conditions. They’ll check for swollen joints which might suggest arthritis, rather than fibromyalgia.

Tests to check for some of these conditions include urine and blood tests. You may also have X-rays and other scans. If you’re found to have another condition, you could still have fibromyalgia as well.

Criteria for diagnosing fibromyalgia

For fibromyalgia to be diagnosed, certain criteria usually have to be met. The most widely used criteria for diagnosis are:

you have pain in multiple areas of your body your symptoms have stayed at a similar level for at least 3months your symptoms can’t be explained by any other reason you feel unrefreshed after sleep you have problems thinking or remembering (cognitive difficulties) you experience fatigue

Diagnosing other conditions

It’s also possible to have other conditions alongside fibromyalgia, like:

depression anxiety irritable bowel syndrome (IBS) osteoarthritis hypermobility spectrum disorder

Identifying all possible conditions will help to guide your treatment.

Treatments

Fibromyalgia is a long term (chronic) condition.

There’s no cure for fibromyalgia. But there are treatments to help relieve some of the symptoms. This can make the condition easier to live with.

Traditional treatments like pain medication aren’t always helpful for people with fibromyalgia. Learning about your condition and finding the best self management approaches for you is the best way to manage it.

A healthcare professional can help you explore your options.

Exercise, movement and activity

Exercise, movement and activity can be helpful way to manage pain.

A physiotherapist can help you to develop self-management skills to reduce the impact of pain on your life. They might help you create a tailored exercise programme suited to your needs, abilities and goals.

Physiotherapy can also help prevent further loss of strength and increase your fitness.

Pain management movement videos

Visit the living with chronic pain page for more information about exercise and relaxation techniques.

Occupational therapy can help you manage your everyday activities around fibromyalgia. The aim is to do this without increasing your pain or overwhelming yourself.

Your occupational therapist may suggest new ways to do things. They may be able to support you to continue to work, if you want to.

Access to Work has information on how to get or stay in work if you have a health condition or disability.

Group support

Some pain clinics offer pain management programmes run by a team of specialists. These specialists can include physiotherapists and psychologists. They can provide support to develop coping skills and manage your activity levels.

Speak to your GP if you think you’d benefit from a pain management programme.

Talking therapies

Talking therapies can help you manage the stress of living with fibromyalgia.

Examples of talking therapies are:

cognitive behavioural therapy (CBT) – a treatment approach to help you understand the link between how we think and what we do acceptance and commitment therapy (ACT) – often used for pain management

Medication

Medication can’t treat fibromyalgia but it can help reduce some symptoms. Speak to your GP or pain specialist to find out the potential benefits and risks.

Your GP will likely suggest you try exercise, CBT and physiotherapy first. This is because these treatments are more likely to help.

Antidepressants can help some people with fibromyalgia. They help:

relieve pain treat sleep problems

This can be useful even if you haven’t been diagnosed with depression.

Other medications can be used for the treatment of fibromyalgia symptoms, but they’re likely to be less effective.

Speak to your GP, pharmacist or healthcare professional if you’re taking medication and you don’t feel its helping.

Farting
of stomach liver and gastrointestinal tract

There are things you can do if you fart a lot or your farts are smelly.

Causes

When you swallow food, water or saliva, you also swallow small amounts of air. This collects in the digestive system. The body needs to get rid of the build-up by farting or burping. Gases can also build up when you digest food.


Excessive farting can be caused by:

swallowing more air than usual eating foods that are difficult to digest conditions affecting the digestive system like indigestion or irritable bowel syndrome (IBS) some medicines like non-steroidal anti-inflammatory drugs (NSAIDs), statins and some laxatives

Do not stop or change your medication without speaking to your GP first. It’s important that you don’t self-diagnose.

Speak to a GP if: farting is affecting your life and self help and pharmacy treatments haven’t worked you have a stomach ache or bloating that’ll not go away or comes back you keep getting constipation or diarrhoea you have lost weight without trying you’ve had blood in your poo for 3 weeks you have signs of an infection like a high temperature, vomiting, chills, joint pain and muscle pain you’re unable to control your bowel movements (involuntary pooing)