Genital herpes
of sexual and reproductive

There are 2 different types of the virus (type 1 and type 2), both of which can affect the genitals. One of the types is the same virus that causes cold sores around the mouth (type 1).

Genital herpes causes painful blisters and sores on and around the genitals. It can also sometimes cause problems if it’s caught for the first time either very early or very late in pregnancy.


Genital herpes causes painful blisters and sores on and around the genitals. It can also sometimes cause problems if it’s caught for the first time either very early or very late in pregnancy.

Symptoms

Many people with the herpes virus do not experience any symptoms when first infected.

If symptoms do occur they usually take between 2 and 12 days after contact to appear.

Sometimes symptoms may not be noticed until months, or sometimes years, after being in contact with the virus. If you do get symptoms, it does not mean you have just caught the virus.

Once you have the herpes infection, the virus stays in your body. It can lie dormant for long periods, but can reactivate in the area that was originally infected. If the virus reactivates, the sores and blisters can reappear. This is known as a ‘recurrent episode’ of genital herpes.

This first episode of genital herpes may last from 2 to 4 weeks. Repeated episodes are not usually as severe, or long, as the first and you may never have a repeat episode.

Symptoms of the first infection can include spots or red bumps around the genital area. These can be very painful. In time, these swellings can break open and form sores or ulcers which gradually crust over, forming new skin as they heal.

Other symptoms include:

pain inside the vagina, head of penis or back passage (rectum) vaginal discharge pain peeing or being unable to pee fever flu-like symptoms, backache, headache and a temperature mild swelling of the lymph glands in the groin, armpits and neck

If you have a recurrent infection, your symptoms may include:

a tingling or burning sensation before blisters appear (this can signal the start of a recurrent infection) painful red blisters, which soon burst to leave ulcers pain inside the vagina, head of penis or back passage

Diagnoses

If you think you may have genital herpes you should make an appointment with your GP or local sexual health services.

If there are symptoms present such as blisters, sores and ulcers, your doctor or nurse may be able to make a diagnosis straight away.

If you have visible blisters, your doctor or nurse may take a swab for testing, to check if this is herpes and what type. This swab can also test for another STI which causes blisters called syphilis.

The genital herpes swab tests are very reliable, though if the ulcer is too dry then it may be less likely to find a positive result.

Treatments

Although there is no known cure for herpes, the symptoms of genital herpes can be treated.

The symptoms of recurrent genital herpes will usually clear up without any treatment. Anti-viral medication can help speed up the healing process and reduce the severity of an episode, if needed.

If you start taking the medication as soon as an outbreak begins, you may shorten or even stop the episode.

Some people experience many recurrences of genital herpes. In these cases, a longer course of tablets should prevent any recurrent episodes.

Talk to your doctor or nurse at the sexual health service, or to your GP, about possible treatment options that may suit you.

It’s important to keep the area clean by bathing the area with warm salty water. Drink enough fluid – such as water or soft drinks – to make your pee (urine) less painful to pass.

If you’re pregnant and find out you have a genital herpes infection, tell your midwife as soon as possible.

As there’s no screening test for herpes, partners are only advised to have a test if they also have symptoms.

Managing genital symptoms
of sexual and reproductive

Symptoms can be caused by a variety of natural changes in your body as well as infections that are not sexually transmitted.

Phone 111 if you: Become very ill and have: severe pain a high temperature nausea and/or vomiting


Phone 111 if you: Become very ill and have: severe pain a high temperature nausea and/or vomiting

Symptoms

Ulcers on the genitals Single ulcers (sores) could be a sign of a recent infection of syphilis, especially if there is no pain. Painful ulcers may be due to herpes, other infections or recent trauma. It can help to take a photo of your ulcer so you can show the sexual health clinician at your appointment. If you think you have mpox (monkeypox) or you’ve come into contact in the last 21 days with someone who has mpox, you should phone your local service before you attend in person. Pelvic pain There are many causes of pain in the lower tummy. For example issues of the bowel or urinary tract and many gynaecological conditions. Some STIs such as gonorrhoea, or chlamydia, can very occasionally spread up into the womb and cause pelvic pain and/or deep pain during sex. If you have pain like this and think you have been at risk of an STI then you should contact your local service. If there is any possibility that you could be pregnant, take a pregnancy test. Discharge from the end of the penis Whether you have discomfort peeing or not, discharge from the end of the penis could mean that you have an STI such as chlamydia or gonorrhoea. Book a consultation online or contact your local sexual health service for advice. Pain, swelling or inflammation around the testicles Gonorrhoea and chlamydia usually affect just the urinary tract. But sometimes infection can spread to the testicle and/or the epididymis (the small tube part next to the testicle). This will cause painful swelling for which you should get treatment urgently. Book a consultation online or phone for advice​​. Multiple painful genital ulcers Having multiple genital ulcers could indicate genital herpes which is the same virus that causes cold sores. Herpes is an extremely common virus. It sometimes causes symptoms which are mostly self-limiting. This means your immune system will deal with this itself, but it can take a few days for symptoms to settle. Sometimes the ulcers are itchy before they become sore. There may be pain when peeing because this stings the ulcers. Milder cases can be diagnosed and treated by your GP. If you’re worried about your symptoms, you could also contact your local sexual health service for advice. Further information about herpes simplex viruses


Spots or lumps on the genitals Sometimes hair follicles (the tiny pockets from where each hair grows) around the genitals or groin area can become inflamed. This is called folliculitis. It may be more common if you shave the area. At first it may look like a small pimple. It may be itchy, and sore but in most cases it will resolve on it’s own. If you have any concerns contact your local sexual health service. Another common cause of new spots or lumps on your genitals is warts. Another possible cause is molluscum. Sometimes, teenagers notice lumps that are completely normal. If you think that the lumps you have noticed are likely to be genital warts they might clear up on their own. One third of warts disappear within 6 months. Your GP practice may be able to prescribe treatment for you or refer you to a sexual health clinic if treatment doesn’t work. Sexual health services available may vary across Scotland. Itching Genital skin can be sensitive. Itching is often a sign that you’re doing something, or using a product, that’s irritating the skin. If itching is your only symptom, it isn’t often related to an STI. Itching around or inside the vagina is often due to thrush. You can get treatment over the counter at your local pharmacy. Change in vaginal bleeding pattern If you’ve changed your method of contraception, then you might notice a change in your bleeding pattern. This should settle but if you have any concerns, talk to your contraception provider. Chlamydia can sometimes cause bleeding after sex or between periods. If you have had unprotected sex with a new sexual partner and notice this type of bleeding, then get tested for STIs. Change in vaginal discharge Read about what to do if you have a change in your vaginal discharge

Genital warts
of sexual and reproductive

This virus is passed on through direct skin-to-skin contact with someone who has HPV on their skin. It can be passed from person to person during vaginal and anal sex. It’s also rarely passed on through oral sex.



You can get warts even if you use condoms or don’t have penetrative sex, as a condom does not cover all of the genital skin.

Symptoms

If you have genital warts, you may notice lumps or growths around your vagina, penis or anus that were not there before. However, you can carry the virus without developing actual warts.

You may develop symptoms years after you have been in contact with the virus so it isn’t possible to know when you came in contact with HPV.

It’s common for warts to appear or re-appear during pregnancy due to a change in how the immune system manages the virus.

Diagnoses

A healthy immune system is usually able to clear the virus, or suppress it, over time. This means that eventually the warts would be cured.

If you think you may have genital warts you should make an appointment with your GP or contact your local sexual health services.

It’s important that warts are diagnosed by a doctor or nurse.

Treatments

Treatment for genital warts needs to be prescribed by a doctor or nurse.

The type of treatment you’ll be offered depends on what your warts are like. The doctor or nurse will discuss this with you. Treatment options include:

cream or liquid freezing surgery

Cream or liquid

You can usually apply this to the warts yourself a few times a week for several weeks.

Freezing

A doctor or nurse freezes the warts with liquid nitrogen, usually every week for 4 weeks.

Surgery

A doctor or nurse can cut, burn or laser the warts off. This is usually only recommended if the warts are not responding or are too large for cream or freezing. Side effects of these treatments include:

bleeding wound infection scarring

Germ cell tumours
of cancer, cancer types in children

More children than ever are surviving childhood cancer. There are 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.

Germ cell tumours can appear at any age. They develop from cells that produce eggs or sperm so germ cell tumours can affect the ovaries or testes. However, it’s possible for a germ cell tumour to develop in other parts of the body.

As a baby develops during pregnancy, the cells producing eggs or sperm normally move to the ovaries or testes. However, occasionally they can settle in other parts of the body where they can develop into tumours. The most common places for this to happen are the bottom of the spine (sacrococcygeal), the brain, chest, and abdomen.

Germ cell tumours are sometimes given different names based on their characteristics. These include yolk-sac tumours, germinomas, embryonal carcinomas, mature teratomas and immature teratomas.

They may be non-cancerous (benign) or cancerous (malignant). Malignant tumours have the ability to grow and spread to other parts of the body.

Benign tumours do not spread but may cause problems by pressing on nearby tissue and organs.

Immature teratomas fall between benign and malignant. They can spread within the abdomen but not beyond, and can be removed with an operation.


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.

Germ cell tumours can appear at any age. They develop from cells that produce eggs or sperm so germ cell tumours can affect the ovaries or testes. However, it’s possible for a germ cell tumour to develop in other parts of the body.

As a baby develops during pregnancy, the cells producing eggs or sperm normally move to the ovaries or testes. However, occasionally they can settle in other parts of the body where they can develop into tumours. The most common places for this to happen are the bottom of the spine (sacrococcygeal), the brain, chest, and abdomen.

Germ cell tumours are sometimes given different names based on their characteristics. These include yolk-sac tumours, germinomas, embryonal carcinomas, mature teratomas and immature teratomas.

They may be non-cancerous (benign) or cancerous (malignant). Malignant tumours have the ability to grow and spread to other parts of the body.

Benign tumours do not spread but may cause problems by pressing on nearby tissue and organs.

Immature teratomas fall between benign and malignant. They can spread within the abdomen but not beyond, and can be removed with an operation.


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.

Germ cell tumours can appear at any age. They develop from cells that produce eggs or sperm so germ cell tumours can affect the ovaries or testes. However, it’s possible for a germ cell tumour to develop in other parts of the body.

As a baby develops during pregnancy, the cells producing eggs or sperm normally move to the ovaries or testes. However, occasionally they can settle in other parts of the body where they can develop into tumours. The most common places for this to happen are the bottom of the spine (sacrococcygeal), the brain, chest, and abdomen.

Germ cell tumours are sometimes given different names based on their characteristics. These include yolk-sac tumours, germinomas, embryonal carcinomas, mature teratomas and immature teratomas.

They may be non-cancerous (benign) or cancerous (malignant). Malignant tumours have the ability to grow and spread to other parts of the body.

Benign tumours do not spread but may cause problems by pressing on nearby tissue and organs.

Immature teratomas fall between benign and malignant. They can spread within the abdomen but not beyond, and can be removed with an operation.

Symptoms

The symptoms depend on where the tumour develops. Usually it starts with a lump that can either be felt or causes other symptoms.

Causes

The cause of germ cell tumours is unknown but research into the causes of different cancers is ongoing.

Diagnoses

Different tests may be needed to diagnose a germ cell tumour. Usually, the doctor will remove a sample of tissue from the lump (a biopsy) for examination under a microscope to find out if it is a cancer or not.

CT or MRI scans may be used to see the exact position of a tumour within the body. Chest X-rays may be taken to see if there’s a tumour in the lungs.

Germ cell tumours often produce proteins called tumour markers that can be measured in the blood. The ones that are produced by germ cell tumours are alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG). Your child will have blood tests to check these tumour markers when they are being diagnosed. The doctors will continue to check these during treatment and after treatment is over.

Sometimes a germ cell tumour can be diagnosed with a tumour marker and scan results so that a biopsy isn’t necessary. This is particularly so if surgery is not needed for treatment, for example if the tumour is in the brain.

Staging

The stage of a cancer describes its size and whether it has spread from where it started. Knowing the stage helps doctors to decide on the most appropriate treatment.

Generally cancer is divided into 4 stages:

stage 1 – the cancer is small, has not spread and has been completely removed stages 2 and 3 – the cancer is larger and may not have been completely removed, or may have spread to nearby organs stage 4 – the cancer has spread to other parts of the body

Cancer that has spread to distant parts of the body and formed new tumours is known as secondary or metastatic cancer.

Treatments

The treatment your child will have usually depends on a number of factors, including the size, position and stage of the tumour. It usually includes either surgery or chemotherapy, or a combination.

A benign tumour can be cured if it is removed by surgery. It may mean removing a testicle or an ovary if this is where the tumour started.

If the tumour is malignant and can be completely removed with surgery, chemotherapy is not always needed, especially if it began in the testis or ovary. If the tumour cannot be removed easily or has spread, your child will be given chemotherapy.

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Germ cell tumours are very sensitive to chemotherapy. It’s usually given as injections and drips (infusions) into a vein.

A combination of drugs is usually given every 3 weeks for 3 or 5 months. The length of time chemotherapy is given for depends on the position of the tumour, the level of AFP, and whether or not the tumour has spread.

Treatment of malignant germ cell tumours in the brain is a little different. Although they are very sensitive to chemotherapy, treatment with radiotherapy is also needed. Radiotherapy is the use of high-energy rays to destroy cancer cells. Unlike germ cell tumours elsewhere in the body, it’s not always necessary to remove germ cell tumours in the brain with surgery.

Side effects of treatment

Treatment often causes side effects, and your child’s doctor will discuss these with you before treatment starts. The operation your child has will be individually planned to try to reduce any possible problems. The surgeon and specialist nurse will discuss this with you.

The side effects of chemotherapy usually gradually improve when treatment is over and many of them can be well controlled.

The side effects of treatment depend on the drugs used but can include:

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

Late side effects

A small number of children may develop long-term side effects of treatment, sometimes many years later. These are not common but may include problems with how the kidneys or lungs work and some hearing loss. Your child’s specialist doctor or nurse will tell you more about any possible late side effects.

If your child has only one ovary or testis removed, they’ll usually still be able to have children in the future.

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 is often provided to help explain things.

Taking part in a research trial is completely voluntary, and you’ll be given plenty of time to decide if it’s right for your child.

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 continue to have regular blood tests during and after treatment, to check their levels of AFP and HCG. If the levels rise, this indicates that the tumour might have come back and further treatment is needed.

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.

Glandular fever
of infections and poisoning

Glandular fever is a type of viral infection that mostly affects young adults.

It’s also known as infectious mononucleosis, or ‘mono’.

Common symptoms include:

a high temperature (fever) a severely sore throat swollen glands in the neck fatigue (extreme tiredness)

While the symptoms of glandular fever can be very unpleasant, most of them should pass within 2 to 3 weeks. Fatigue, however, can occasionally last several months.

Read more about the symptoms of glandular fever.

Symptoms

Symptoms of glandular fever are thought to take around 1 to 2 months to develop after infection with the Epstein-Barr virus (EBV).


The most common symptoms of the condition are:

a high temperature (fever) a sore throat – this is usually more painful than any you may have had before swollen glands in your neck and possibly in other parts of your body, such as under your armpits fatigue (extreme tiredness)


Glandular fever can also cause:

a general sense of feeling unwell aching muscles chills sweats loss of appetite pain around or behind your eyes swollen tonsils and adenoids (small lumps of tissue at the back of the nose), which may affect your breathing the inside of your throat to become very red and ooze fluid small red or purple spots on the roof of your mouth a rash swelling or ‘puffiness’ around your eyes a tender or swollen tummy jaundice (yellowing of the skin and whites of the eyes)

Some of these symptoms may develop a few days before the main symptoms mentioned above.

Causes

Glandular fever is caused by the Epstein-Barr virus (EBV). This virus is found in the saliva of infected people and can be spread through:

kissing – glandular fever is often referred to as the ‘kissing disease’ exposure to coughs and sneezes sharing eating and drinking utensils, such as cups, glasses and unwashed cutlery

EBV may be found in the saliva of someone who has had glandular fever for several months after their symptoms pass, and some people may continue to have the virus in their saliva on and off for years.

If you have EBV, it’s a good idea to take steps to avoid infecting others while you are ill, such as not kissing other people, but there’s no need no need to avoid all contact with others as the chances of passing on the infection are generally low.

Read more about the causes of glandular fever.


Glandular fever is caused by the Epstein-Barr virus (EBV). EBV is most often spread through the saliva of someone who carries the infection.

For example, it can be spread through:

kissing – glandular fever is sometimes referred to as the ‘kissing disease’ sharing food and drinks sharing toothbrushes exposure to coughs and sneezes

Small children may be infected by chewing toys that have been contaminated with the virus.

When you come into contact with infected saliva, the virus can infect the cells on the lining of your throat.

The infection is then passed into your white blood cells before spreading through the lymphatic system.

This is a series of glands (nodes) found throughout your body that allows many of the cells that your immune system needs to travel around the body.

After the infection has passed, people develop lifelong immunity to the virus and most won’t develop symptoms again.

Many people are first exposed to EBV during childhood, when the infection causes few symptoms and often goes unrecognised before it eventually passes.

Young adults may be most at risk of glandular fever because they might not have been exposed to the virus when they were younger, and the infection tends to produce more severe symptoms when you’re older.

Diagnoses

To diagnose glandular fever, your GP will first ask about your symptoms before carrying out a physical examination. They’ll look for signs of glandular fever, such as swollen glands, tonsils, liver and spleen.

Your GP may also recommend a blood test to help confirm the diagnosis and rule out infections that can cause similar symptoms, such as cytomegalovirus (CMV), rubella, mumps and toxoplasmosis.

Treatments

You should contact your GP if you suspect that you or your child has glandular fever.

While there is little your GP can do in terms of treatment, they can provide advice and support to help you control your symptoms and reduce the risk of passing the infection on to others.

You should go to your local accident and emergency (A&E) department or phone 999 for an ambulance if you have glandular fever and you:

develop a rasping breath (stridor) or have any breathing difficulties find swallowing fluids difficult develop intense abdominal pain

These symptoms can be a sign of a complication of glandular fever that may need to be treated in hospital.

Fever in adults self-help guideComplete this guide to assess your symptoms and find out if you should visit A&E, your GP, pharmacist or treat your condition at home.Self-help guide: Fever in adults


There is no cure for glandular fever. But there are simple treatments and measures that can help reduce the symptoms while you wait for your body to control the infection.

These include:

drinking plenty of fluids taking over-the-counter painkillers, such as paracetamol or ibuprofen getting plenty of rest and gradually increasing your activity as your energy levels improve

Occasionally, antibiotics or corticosteroids may be used if you develop complications of glandular fever.

Some people with particularly severe symptoms may need to be looked after in hospital for a few days.

Read more about treating glandular fever.


You should contact your GP if you suspect that you or your child has glandular fever.

While there is little your GP can do in terms of treatment other than provide advice and support, blood tests may be needed to rule out less common but more serious causes of your symptoms, such as hepatitis (a viral infection that affects the liver).

You should go to your local accident and emergency (A&E) department or phone 999 for an ambulance if you have glandular fever and you:

develop a rasping breath (stridor) or have any breathing difficulties find swallowing fluids difficult develop intense abdominal pain

If you have these symptoms, you may need to be looked after in hospital for a few days.

Read more about treating glandular fever.


There is currently no cure for glandular fever, but the symptoms should pass within a few weeks. There are things you can do to help control your symptoms.


Most people are able to recover from glandular fever at home, but hospital treatment may be necessary for a few days if you or your child:

develop a rasping breath (stridor) or have any breathing difficulties find swallowing fluids difficult develop intense abdominal pain

Treatment in hospital may involve receiving fluids or antibiotics directly into a vein (intravenously), corticosteroid injections and pain relief.

In a small number of cases, emergency surgery to remove the spleen (splenectomy) may be needed if it ruptures.

Preventions

There is no need to be isolated from others if you have glandular fever as most people will already be immune to the Epstein-Barr virus (EBV).

You can return to work, college or school as soon as you feel well enough. There’s little risk of spreading the infection to others as long as you follow commonsense precautions while you are ill, such as not kissing other people or sharing utensils.

It’s also important to thoroughly clean anything that may have been contaminated by saliva until you have recovered.

Complications

Complications associated with glandular fever are uncommon, but when they do occur they can be serious. They can include:

further infections of other areas of the body, including the brain, liver and lungs severe anaemia (a lack of oxygen-carrying red blood cells) breathing difficulties as a result of the tonsils becoming significantly swollen a ruptured (burst) spleen, which may need to be treated with surgery

Read more about the complications of glandular fever.


Most people with glandular fever will recover in 2 or 3 weeks and won’t experience any further problems.

However, complications can develop in a few cases.


In less than 1 in every 100 cases, the Epstein-Barr virus (EBV) can affect the nervous system and trigger a range of neurological complications, including:

Guillain-Barré syndrome – where the nerves become inflamed, causing symptoms such as numbness, weakness and temporary paralysis Bell’s palsy – where the muscles on one side of the face become temporarily weak or paralysed viral meningitis – an infection of the protective membranes that surround the brain and spinal cord; although unpleasant, viral meningitis is much less serious than bacterial meningitis, which is life threatening encephalitis – an infection of the brain

These complications will often need specific treatment, but more than four out of every five people with them will make a full recovery.

Gonorrhoea
of sexual and reproductive

sharing sex toys that aren’t washed or covered with a new condom each time they’re used infected semen or vaginal fluid getting into your eye it can also be passed to a newborn during childbirth


If symptoms do appear, they usually show up between 1 to 14 days after coming into contact with the infection.

Symptoms of gonorrrhoea may include:

green or yellow fluid coming out of the penis pain or a burning sensation when peeing discomfort and swelling of the testicles increased discharge from the vagina pain in the lower tummy, particularly during sex bleeding in between periods or after sex

Gonorrhoea can also infect the throat, anus or eyes. You may experience pain or discharge in these areas if there is an infection. Gonorrhoea in the throat usually has no symptoms.

Symptoms

Many people with gonorrhoea will not notice any symptoms.

If symptoms do appear, they usually show up between 1 to 14 days after coming into contact with the infection.

Symptoms of gonorrrhoea may include:

green or yellow fluid coming out of the penis pain or a burning sensation when peeing discomfort and swelling of the testicles increased discharge from the vagina pain in the lower tummy, particularly during sex bleeding in between periods or after sex

Gonorrhoea can also infect the throat, anus or eyes. You may experience pain or discharge in these areas if there is an infection. Gonorrhoea in the throat usually has no symptoms.

Diagnoses

If you think you have gonorrhoea you should make an appointment with your GP or local sexual health services.

The tests for gonorrhoea are simple, painless and very reliable.

They involve sending a swab from the area thought to be infected to a lab for analysis. In most cases, you don’t have to be examined by a doctor or nurse and can often collect the sample yourself.

There are 2 main ways the sample can be collected:

using a swab – a small cotton bud is gently wiped over the area that might be infected, such as inside the vagina, anus or throat peeing into a container – this should ideally be done at least 1 or 2 hours after you last peed

Some sexual health clinics may be able to carry out rapid tests and give you your test results straight away. Otherwise, you will have to wait up to 2 weeks to get the results.

Treatments

Gonorrhoea is treated with antibiotics usually given as an injection. If this is not suitable it can in some cases be treated with tablets.

Some strains of gonorrhoea are becoming resistant to antibiotics. This can make it more difficult to treat. Resistance is checked by sending an additional swab to look for resistance and re-testing for the infection 3 weeks after treatment.

If there’s a high chance that you have gonorrhoea, you may be given treatment before you get your results back.

You may also be offered treatment if your partner is found to have gonorrhoea.

Tell the doctor or nurse if you:

are pregnant think you might be pregnant are breastfeeding

This may make a difference to the antibiotic you’re prescribed.

If your infection is untreated you may pass it onto other sexual partners.

Gonorrohea can occasionally lead to other more serious problems such as pelvic inflammatory disease (PID) when the infection gets into the womb and fallopian tubes. This could lead to problems such as infertility and ectopic pregnancy.

If you have a gonorrhoea infection during pregnancy it can result in giving birth to the baby early (premature birth). In addition, the infection can be passed on to the baby during birth and result in a severe eye infection in the infant.

The infection can also spread to the testicles causing pain, swelling and inflammation and in some cases infertility.

Gout
of muscle bone and joints, conditions

Gout is a type of arthritis in which small crystals form inside and around the joints. It causes sudden attacks of severe pain and swelling.

It’s estimated that between one and two in every 100 people in the UK are affected by gout.

The condition mainly affects men over 30 and women after the menopause. Overall, gout is more common in men than women.

Gout can be extremely painful and debilitating, but treatments are available to help relieve the symptoms and prevent further attacks.

Symptoms

Any joint can be affected by gout, but it usually affects joints towards the ends of the limbs, such as the toes, ankles, knees and fingers.

Signs and symptoms of gout include:

severe pain in one or more joints the joint feeling hot and very tender swelling in and around the affected joint red, shiny skin over the affected joint  

Symptoms develop rapidly over a few hours and typically last three to 10 days. After this time the pain should pass and the joint should return to normal.

Almost everyone with gout will experience further attacks at some point, usually within a year.

Read more about the symptoms of gout.


The main symptom of gout is a sudden attack of severe pain in one or more joints, typically your big toe.

Other symptoms can include:

the joint feeling hot and very tender, to the point of being unable to bear anything touching it swelling in and around the affected joint red, shiny skin over the affected joint peeling, itchy and flaky skin as the swelling goes down

The intense pain can make getting around difficult. Even the light pressure of a bed cover or blanket can be unbearable.


Attacks of gout tend to:

occur at night, although they can happen at any time develop quickly over a few hours last between three and 10 days – after this time, the affected joint should start to return to normal, but the problem can persist if treatment isn’t started early come back – you may experience attacks every few months or years become more frequent over time if not treated

It’s difficult to predict how often attacks will occur and when exactly they will happen.

Causes

Gout is caused by a build-up of a substance called uric acid in the blood.

If you produce too much uric acid or your kidneys don’t filter enough out, it can build up and cause tiny sharp crystals to form in and around joints. These crystals can cause the joint to become inflamed (red and swollen) and painful.

Things that may increase your chances of getting gout include:

obesity, high blood pressure and/or diabetes having a close relative with gout kidney problems eating foods that cause a build-up of uric acid, such as red meat, offal and seafood drinking too much beer or spirits

Read more about the causes of gout.


Sometimes gout can lead to further problems, particularly if it’s left untreated.

These can include:

kidney stones small firm lumps of uric acid crystals under the skin called tophi permanent joint damage

Read more about the complications of gout.


Gout is caused by small crystals forming in the joints, resulting in severe pain, tenderness and swelling.

These crystals can grow when a waste product called uric acid starts to build up to high levels in the body.

Diagnoses

Your GP may suspect gout based on your symptoms. Sometimes further tests will be needed to confirm the diagnosis and rule out other possible causes.


Many conditions can cause gout-like symptoms.

Your GP may be unable to make a firm diagnosis straight away and you may be referred for further tests. These will either confirm the diagnosis of gout or rule out other conditions.

Joint fluid test

A sample of fluid may be taken from the affected joint. The fluid can be checked for the small crystals that cause gout, and it can be tested for infection to rule out septic arthritis.

Blood test

A blood test known as a serum uric acid test may be used to measure the amount of uric acid in your blood. A high level or uric acid is often associated with gout.

It’s sometimes best to wait until two to four weeks after an attack of gout before this test is carried out, as the level of uric acid in your blood is often not raised at the time of an attack. This is because the level of uric acid in your blood can drop when uric acid crystals form in the joints.

X-ray

An X-ray is rarely used to diagnose gout because the condition isn’t usually detectable using this method.

However, an X-ray is sometimes used to help rule out similar conditions that affect the joints, such as chondrocalcinosis (a build-up of calcium crystals in the joints) or to assess whether there has been any joint damage due to repeated or persistent attacks of gout.

Ultrasound scan

An ultrasound scan of an affected joint is a simple and safe investigation that’s increasingly used to detect crystals in the joints. It can also detect crystals deep in the skin that aren’t obvious during a physical examination.

Treatments

See your GP if you suspect you have gout and it hasn’t been previously diagnosed, particularly if the pain keeps getting worse and you also have a high temperature (fever).

It’s important that a diagnosis is confirmed because other conditions that require urgent treatment, such as an infected joint, can sometimes cause similar symptoms.

If you’ve already been diagnosed with gout and you have an attack, see your GP if any medication you’ve been prescribed (see below) doesn’t start working within a couple of days.

Read more about diagnosing gout.


If you have gout, treatment is available from your GP to:

relieve symptoms during an attack – this can be done using ice packs and by taking medications such as non-steroidal anti-inflammatory drugs (NSAIDs), colchicine or corticosteroids prevent further attacks – through a combination of lifestyle changes, such as losing weight or changing your diet, and taking medication that lowers uric acid levels, such as allopurinol 

With treatment, many people are able to reduce their uric acid levels sufficiently to dissolve the crystals that cause gout – and as a result have no further attacks. However, lifelong treatment is usually required.

Read more about treating gout.


See your GP if you suspect you have gout and it hasn’t been previously diagnosed.

Contact your GP immediately or call the 111 service if you have both:

severe, worsening joint pain and swelling a high temperature (fever) of 38C (100.4F) or above

This could mean you have an infection inside the joint (septic arthritis).

If you’ve already been diagnosed with gout and you have an attack, see your GP if any medication you’ve been prescribed doesn’t start working within a couple of days.

Read more about diagnosing gout and treating gout.


Treatment for gout includes pain relief to help you cope with a gout attack, as well as medication and lifestyle changes to prevent further attacks.

Preventions

You can reduce your chances of having further gout attacks by taking medication and making lifestyle changes to reduce the level of uric acid in your body.

Medication

Medication to reduce uric acid levels – known as urate-lowering therapy (ULT) – is usually recommended if you have recurrent attacks of gout or you have complications of gout.

Most people with gout will eventually need to have ULT, so you may want to discuss the advantages and disadvantages of this treatment with your doctor as soon as you’ve been diagnosed with gout.

They should explain that while ULT can significantly reduce your risk of having further attacks, the medication needs to be taken on a daily basis for the rest of your life and there’s a small risk of side effects.

If you decide to start ULT, a medicine called allopurinol is usually tried first. If this isn’t suitable or doesn’t work, other medications may be used instead. These medications are described below.

Allopurinol

Allopurinol helps reduce the production of uric acid. It can help prevent gout attacks, although it won’t help relieve symptoms during an attack.

Allopurinol is a tablet taken once a day. When you first start taking it, your dose will be adjusted to make sure the level of uric acid in your blood is low enough. Regular blood tests will be needed to monitor this until the most effective dose is found.

Allopurinol can sometimes cause a gout attack soon after you start taking it and it can take up to a year or two before no further attacks occur. It’s important to persevere with treatment even if you do have attacks during this time.

To help relieve attacks, your doctor will prescribe one of the pain relieving medications described above to take alongside your allopurinol at first.

Most people taking allopurinol won’t experience any significant side effects. However, side effects can include:

a rash – this is usually mild and goes away on its own, but it can be a sign of an allergy; if you develop a rash, stop taking the medication immediately and contact your GP for advice indigestion headaches diarrhoea

Febuxostat

Like allopurinol, febuxostat is a medication taken once a day that reduces the body’s production of uric acid. It’s often used if allopurinol isn’t suitable or causes troublesome side effects.

As with allopurinol, febuxostat can make your symptoms worse when you first start taking it. Your doctor will initially prescribe one of the pain relieving medications described in case you experience attacks.

Side effects of febuxostat can include:

diarrhoea feeling sick headaches a rash

Other medications

Less commonly used ULT medications include benzbromarone and sulfinpyrazone.

These types of medication tend to only be used if people are unable to take allopurinol or febuxostat. They need to be prescribed under the supervision of a specialist.

Lifestyle changes

Certain lifestyle changes can also help reduce your risk of experiencing further attacks of gout, including:

avoiding foods containing high levels of purine (the chemical involved in the production of uric acid), such as red meat, offal, oily fish, seafood and foods containing yeast extract. avoiding sugary drinks and snacks – these are associated with an increased risk of gout maintaining a healthy weight – follow a balanced diet; don’t crash diet or try high-protein, low-carbohydrate diets taking regular exercise – try activities that don’t put too much strain on your joints, such as swimming drinking plenty of water – keeping yourself well hydrated will reduce the risk of crystals forming in your joints cutting down on alcohol – avoid beer and spirits in particular and don’t binge drink

There’s some evidence to suggest that taking regular vitamin C supplements can reduce gout attacks, although the effect may only be small. Talk to your GP first if you’re thinking about taking vitamin C supplements, as they aren’t suitable or safe for everyone.

Complications

Complications of gout can include small lumps forming under the skin (tophi), joint damage and kidney stones. These are more likely to occur if gout is left untreated.

Gum disease
of mouth

If you have a dental problem you should, in the first instance always phone the dental practice that you normally attend. If you are not registered with any dental practice then you should read our advice on dental emergencies.

Gum disease is a very common condition where the gums become swollen, sore or infected.

Most adults in the UK have gum disease to some degree and most people experience it at least once. It’s much less common in children.

If you have gum disease, your gums may bleed when you brush your teeth and you may have bad breath. This early stage of gum disease is known as gingivitis.

If gingivitis isn’t treated, a condition called periodontitis can develop. This affects more tissues that support teeth and hold them in place.

If periodontitis isn’t treated, the bone in your jaw may be damaged and small spaces can open up between the gum and teeth. Your teeth can become loose and may eventually fall out.

Read more about the symptoms of gum disease.

Symptoms

Healthy gums should be pink, firm and keep your teeth securely in place. Your gums shouldn’t bleed when you touch or brush them.

Gum disease isn’t always painful and you may be unaware you have it. It’s important to have regular dental check-ups.


The initial symptoms of gum disease can include:

red and swollen gums bleeding gums after brushing or flossing your teeth

This stage of gum disease is called gingivitis.


If gingivitis is untreated, the tissues and bone that support the teeth can also become affected. This is known as periodontitis, or periodontal disease.

Symptoms of periodontitis can include:

bad breath (halitosis) an unpleasant taste in your mouth loose teeth that can make eating difficult gum abscesses (collections of pus that develop under your gums or teeth)

Causes

Gum disease is caused by a build-up of plaque on the teeth. Plaque is a sticky substance that contains bacteria.

Some bacteria in plaque are harmless, but some are harmful for the health of your gums. If you don’t remove plaque from your teeth by brushing them, it builds up and irritates your gums. This can lead to redness with bleeding, swelling and soreness.

Read more about the causes of gum disease.


Gum disease can be caused by a number of factors, but poor oral hygiene is the most common cause.

Poor oral hygiene, such as not brushing your teeth properly or regularly, can cause plaque to build up on your teeth.

Treatments

Mild cases of gum disease can usually be treated by maintaining a good level of oral hygiene. This includes brushing your teeth at least twice a day and flossing regularly. You should also make sure you attend regular dental check-ups.

In most cases, your dentist or dental hygienist will be able to give your teeth a thorough clean and remove any hardened plaque (tartar). They’ll also be able to show you how to clean your teeth effectively to help prevent plaque building up in the future.

If you have severe gum disease, you’ll usually need to have further medical and dental treatment and, in some cases, surgery may need to be carried out. This will usually be performed by a specialist in gum problems (periodontics).

Read more about treating gum disease and keeping your teeth clean.


You should make an appointment to see your dentist if you think you may have gum disease or ANUG.

If you don’t currently have a dentist, search for a dentist near you.

Read more about treating gum disease.


The best way to treat gum disease is to practise good oral hygiene, although additional dental and medical treatments are sometimes necessary.


Some of the dental treatments described below may also be recommended if you have gum disease.

Scale and polish

To remove plaque and tartar (hardened plaque) that can build up on your teeth, your dentist may suggest that you have your teeth scaled and polished. This is a ‘professional clean’ usually carried out at your dental surgery by a dental hygienist.

The dental hygienist will scrape away plaque and tartar from your teeth using special instruments, then polish your teeth to remove marks or stains. If a lot of plaque or tartar has built up, you may need to have more than one scale and polish.

The price of a scale and polish can vary depending on what needs to be carried out, so ask your dental hygienist how much it will cost beforehand.

Root planing

In some cases of gum disease, root planing (debridement) may be required. This is a deep clean under the gums that gets rid of bacteria from the roots of your teeth.

Before having the treatment, you may need to have a local anaesthetic (painkilling medication) to numb the area. You may experience some pain and discomfort for up to 48 hours after having root planing.

Further treatment

If you have severe gum disease, you may need further treatment, such as periodontal surgery. In some cases, it’s necessary to remove the affected tooth. Your dentist will be able to tell you about the procedure needed and how it’s carried out. If necessary, they can refer you to a specialist.

If you’re having surgery or root planing, you may be given antibiotics (medication to treat infections). Your dentist will tell you whether this is necessary.

Preventions

Mild cases of gum disease can usually be treated by maintaining a good level of oral hygiene. This includes brushing your teeth at least twice a day and flossing regularly. You should also make sure you attend regular dental check-ups.

In most cases, your dentist or dental hygienist will be able to give your teeth a thorough clean and remove any hardened plaque (tartar). They’ll also be able to show you how to clean your teeth effectively to help prevent plaque building up in the future.

If you have severe gum disease, you’ll usually need to have further medical and dental treatment and, in some cases, surgery may need to be carried out. This will usually be performed by a specialist in gum problems (periodontics).

Read more about treating gum disease and keeping your teeth clean.

Complications

If you have untreated gum disease that develops into periodontitis, it can lead to further complications, such as:

gum abscesses (painful collections of pus) receding gums loose teeth loss of teeth

Read more about the complications of gum disease.


If you develop gingivitis and don’t have the plaque or tartar (hardened plaque) removed from your teeth, the condition may get worse and lead to periodontitis.

You may develop further complications if you don’t treat periodontitis (where the tissue that supports teeth is affected), including:

recurrent gum abscesses (painful collections of pus) increasing damage to the periodontal ligament (the tissue that connects the tooth to the socket) increasing damage to and loss of the alveolar bone (the bone in the jaw that contains the sockets of the teeth) receding gums loose teeth loss of teeth


Gum disease has also been associated with an increased risk for a number of other health conditions, including:

cardiovascular disease lung infections if affected during pregnancy, premature labour and having a baby with a low birth weight

However, while people with gum disease may have an increased risk of these problems, there isn’t currently any clear evidence that gum disease directly causes them.

Haemorrhoids (piles)
of stomach liver and gastrointestinal tract

Haemorrhoids, also known as piles, are swellings containing enlarged blood vessels that are found inside or around the bottom (the rectum and anus).

In many cases, haemorrhoids don’t cause symptoms, and some people don’t even realise they have them. However, when symptoms do occur, they may include:

bleeding after passing a stool (the blood is usually bright red) itchy bottom a lump hanging down outside of the anus, which may need to be pushed back in after passing a stool a mucus discharge after passing a stool soreness, redness and swelling around your anus

Haemorrhoids aren’t usually painful, unless their blood supply slows down or is interrupted.

Causes

The exact cause of haemorrhoids is unclear, but they’re associated with increased pressure in the blood vessels in and around your anus. This pressure can cause the blood vessels in your back passage to become swollen and inflamed.

Many cases are thought to be caused by too much straining on the toilet, due to prolonged constipation – this is often due to a lack of fibre in a person’s diet. Chronic (long-term) diarrhoea can also make you more vulnerable to getting haemorrhoids.

Other factors that might increase your risk of developing haemorrhoids include:

being overweight or obese age – as you get older, your body’s supporting tissues get weaker, increasing your risk of haemorrhoids being pregnant – which can place increased pressure on your pelvic blood vessels, causing them to enlarge (read more about common pregnancy problems) having a family history of haemorrhoids regularly lifting heavy objects a persistent cough or repeated vomiting sitting down for long periods of time

Diagnoses

Your GP can diagnose haemorrhoids (piles) by examining your back passage to check for swollen blood vessels.

Some people with haemorrhoids are reluctant to see their GP. However, there’s no need to be embarrassed – all GPs are used to diagnosing and treating piles.

It’s important to tell your GP about all of your symptoms – for example, tell them if you’ve recently lost a lot of weight, if your bowel movements have changed, or if your stools have become dark or sticky.

Treatments

See your GP if you have persistent or severe symptoms of haemorrhoids. You should always get any rectal bleeding checked out, so your doctor can rule out more potentially serious causes.

The symptoms of haemorrhoids often clear up on their own or with simple treatments that can be bought from a pharmacy without a prescription. However, speak to your GP if your symptoms don’t get better or if you experience pain or bleeding.

Your GP can often diagnose haemorrhoids using a simple internal examination of your back passage, although they may need to refer you to a colorectal specialist for diagnosis and treatment.

Some people with haemorrhoids are reluctant to see their GP. However, there’s no need to be embarrassed, because GPs are very used to diagnosing and treating haemorrhoids.

Read more about diagnosing haemorrhoids.


Haemorrhoid symptoms often settle down after a few days, without needing treatment. Haemorrhoids that occur during pregnancy often get better after giving birth.

However, making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended. These can include:

gradually increasing the amount of fibre in your diet – good sources of fibre include fruit, vegetables, wholegrain rice, wholewheat pasta and bread, pulses and beans, seeds, nuts and oats drinking plenty of fluid – particularly water, but avoiding or cutting down on caffeine and alcohol not delaying going to the toilet – ignoring the urge to empty your bowels can make your stools harder and drier, which can lead to straining when you do go to the toilet avoiding medication that causes constipation – such as painkillers that contain codeine losing weight (if you’re overweight) exercising regularly – can help prevent constipation, reduce your blood pressure and help you lose weight

These measures can also reduce the risk of haemorrhoids returning, or even developing in the first place.

Medication that you apply directly to your back passage (known as topical treatments) or tablets bought from a pharmacy or prescribed by your GP may ease your symptoms and make it easier for you to pass stools.

There are various treatment options for more severe haemorrhoids. One of these options is banding, which is a non-surgical procedure where a very tight elastic band is put around the base of the haemorrhoid to cut off its blood supply. The haemorrhoid should fall off after about a week.

Surgery carried out under general anaesthetic (where you’re unconscious) is sometimes used to remove or shrink large or external haemorrhoids.

Read more about treating haemorrhoids and surgery for haemorrhoids.


Haemorrhoids (piles) often clear up by themselves after a few days. However, there are many treatments that can reduce itching and discomfort.

Making simple dietary changes and not straining on the toilet are often recommended first.

Creams, ointments and suppositories (which you insert into your bottom) are available from pharmacies without a prescription. They can be used to relieve any swelling and discomfort.

If more intensive treatment is needed, the type will depend on where your haemorrhoids are in your anal canal – the lower third (closest to your anus) or the upper two-thirds. The lower third contain nerves which can transmit pain, while the upper two-thirds do not.

Non-surgical treatments for haemorrhoids in the lower part of the canal are likely to be very painful, because the nerves in this area can detect pain. In these cases, haemorrhoid surgery will usually be recommended.

The various treatments for haemorrhoids are outlined below. 


If dietary changes and medication don’t improve your symptoms, your GP may refer you to a specialist. They can confirm whether you have haemorrhoids and recommend appropriate treatment.

If you have haemorrhoids in the upper part of your anal canal, non-surgical procedures such as banding and sclerotherapy may be recommended.

Banding

Banding involves placing a very tight elastic band around the base of your haemorrhoids to cut off their blood supply. The haemorrhoids should then fall off within about a week of having the treatment.

Banding is usually a day procedure that doesn’t need an anaesthetic, and most people can get back to their normal activities the next day. You may feel some pain or discomfort for a day or so afterwards. Normal painkillers are usually adequate, but your GP can prescribe something stronger, if needed.

You may not realise that your haemorrhoids have fallen off, as they should pass out of your body when you go to the toilet. If you notice some mucus discharge within a week of the procedure, it usually means that the haemorrhoids have fallen off.

Directly after the procedure, you may notice blood on the toilet paper after going to the toilet. This is normal, but there shouldn’t be a lot of bleeding. If you pass a lot of bright red blood or blood clots (solid lumps of blood), go to your nearest accident and emergency (A&E) department immediately.

Ulcers (open sores) can occur at the site of the banding, although these usually heal without needing further treatment.

Injections (sclerotherapy)

A treatment called sclerotherapy may be used as an alternative to banding.

During sclerotherapy, a chemical solution is injected into the blood vessels in your back passage. This relieves pain by numbing the nerve endings at the site of the injection. It also hardens the tissue of the haemorrhoid so that a scar is formed. After about 4 to 6 weeks, the haemorrhoid should decrease in size or shrivel up.

After the injection, you should avoid strenuous exercise for the rest of the day. You may experience minor pain for a while and may bleed a little. You should be able to resume normal activities, including work, the day after the procedure.

Electrotherapy

Electrotherapy, also known as electrocoagulation, is another alternative to banding for people with smaller haemorrhoids.

During the procedure, a device called a proctoscope is inserted into the anus to locate the haemorrhoid. An electric current is then passed through a small metal probe that’s placed at the base of the haemorrhoid, above the dentate line. The specialist can control the electric current using controls attached to the probe.

The aim of electrotherapy is to cause the blood supplying the haemorrhoid to coagulate (thicken), which causes the haemorrhoid to shrink. If necessary, more than one haemorrhoid can be treated during each session.

Electrotherapy can either be carried out on outpatient basis using a low electric current, or a higher dose can be given while the person is under a general anaesthetic or spinal anaesthetic.

You may experience some mild pain during or after electrotherapy, but in most cases this doesn’t last long. Rectal bleeding is another possible side effect of the procedure, but this is usually short-lived.  

Electrotherapy is recommended by the National Institute for Health and Care Excellence (NICE), and has been shown to be an effective method of treating smaller haemorrhoids. It can also be used as an alternative to surgery for treating larger haemorrhoids, but there’s less evidence of its effectiveness.


Other treatment options are available, including freezing and laser treatment. However, the number of NHS or private surgeons who perform these treatments is limited.


Seek medical advice from the hospital unit where the surgery was carried out, or from your GP, if you experience:

excessive bleeding a high temperature (fever) problems urinating worsening pain or swelling around your anus

If you’re unable to contact the hospital or your GP, phone NHS 24’s 111 service for advice or visit your nearest accident and emergency (A&E) department.

Preventions

Haemorrhoid symptoms often settle down after a few days, without needing treatment. Haemorrhoids that occur during pregnancy often get better after giving birth.

However, making lifestyle changes to reduce the strain on the blood vessels in and around your anus is often recommended. These can include:

gradually increasing the amount of fibre in your diet – good sources of fibre include fruit, vegetables, wholegrain rice, wholewheat pasta and bread, pulses and beans, seeds, nuts and oats drinking plenty of fluid – particularly water, but avoiding or cutting down on caffeine and alcohol not delaying going to the toilet – ignoring the urge to empty your bowels can make your stools harder and drier, which can lead to straining when you do go to the toilet avoiding medication that causes constipation – such as painkillers that contain codeine losing weight (if you’re overweight) exercising regularly – can help prevent constipation, reduce your blood pressure and help you lose weight

These measures can also reduce the risk of haemorrhoids returning, or even developing in the first place.

Medication that you apply directly to your back passage (known as topical treatments) or tablets bought from a pharmacy or prescribed by your GP may ease your symptoms and make it easier for you to pass stools.

There are various treatment options for more severe haemorrhoids. One of these options is banding, which is a non-surgical procedure where a very tight elastic band is put around the base of the haemorrhoid to cut off its blood supply. The haemorrhoid should fall off after about a week.

Surgery carried out under general anaesthetic (where you’re unconscious) is sometimes used to remove or shrink large or external haemorrhoids.

Read more about treating haemorrhoids and surgery for haemorrhoids.

Hand, foot and mouth disease
of infections and poisoning

It’s most common in young children – particularly those under 10 – but can affect older children and adults as well.

Hand, foot and mouth disease can be unpleasant, but it will usually clear up by itself within 7 to 10 days. You can normally look after yourself or your child at home.

The infection is not related to foot and mouth disease, which affects cattle, sheep and pigs.


Hand, foot and mouth disease can be unpleasant, but it will usually clear up by itself within 7 to 10 days. You can normally look after yourself or your child at home.

The infection is not related to foot and mouth disease, which affects cattle, sheep and pigs.


The infection is not related to foot and mouth disease, which affects cattle, sheep and pigs.

Symptoms

The symptoms of hand, foot and mouth disease usually develop between 3 and 5 days after being exposed to the infection.

The first symptoms may include:

a high temperature (fever), usually around 38°C to 39°C (100.4-102.2°F) a general sense of feeling unwell loss of appetite coughing abdominal (tummy) pain a sore throat and mouth 

Treatments

You don’t usually need medical attention if you think you or your child has hand, foot and mouth disease. The infection will usually pass in 7 to 10 days, and there isn’t much your doctor can do.

Antibiotics won’t help as hand, foot and mouth disease is caused by a virus.

If you’re unsure whether you or your child has hand, foot and mouth disease, you can phone 111 or your GP for advice.

Get medical advice if: your child is unable or unwilling to drink any fluids your child has signs of dehydration, such as unresponsiveness, passing small amounts of urine or no urine at all, or cold hands and feet your child develops fits (seizures), confusion, weakness or a loss of consciousness your child is under three months old and has a temperature of 38°C (101°F) or above, or is between 3 and 6 months old and has a temperature of 39°C (102°F) or above the skin becomes very painful, red, swollen and hot, or there’s a discharge of pus the symptoms are getting worse or haven’t improved after 7 to 10 days

Get advice from your GP if you’re pregnant and you become infected within a few weeks of your due date. Infection in pregnancy is usually nothing to worry about, but there’s a small chance it could make your baby ill if you’re infected shortly before you give birth.

Read more about the risks of hand, foot and mouth disease in pregnancy

Preventions

It’s not always possible to avoid getting hand, foot and mouth disease, but following this advice can help stop the infection spreading.

Do stay off work, school or nursery until you or your child are feeling better – there’s usually no need to wait until the last blister has healed, provided you’re otherwise welluse tissues to cover your mouth and nose when you cough or sneeze and put used tissues in a bin as soon as possiblewash your hands with soap and water often – particularly after going to the toilet, coughing, sneezing or handling nappies, and before preparing fooddisinfect any surfaces or objects that could be contaminated – it’s best to use a bleach-based household cleanerwash any bedding or clothing that could have become contaminated separately on a hot wash

Don’t do not share cups, utensils, towels and clothes with people who are infected