Try to treat these problems before contacting your doctor. Remember the pharmacist may also be able to give you advice. If you know the name of your condition, please also look at www.patient.co.uk for a large variety of expert reviewed patient information leaflets.
Patients with mild acne can try self-treatment. For more advice visit Embarrassing Problems website which is quite comprehensive and helpful, but if problems persists you should see a doctor.
Bad Breath (halitosis)
Complex problem with a lot of different causes. Avoid smoking and foods that cause bad breath. See your dentist regularly. For in depth advice visit Embarrassing Problems website. If problems persist despite of several different approaches see your doctor.
Back pain in pregnancy
Paracetamol is the mainstay of all pregnancy related pains. However, so called TENS machines often provide great relief with no known adverse effects to the foetus. They can be bought online and at pharmacies at about £10 – £15. Physiotherapy can be helpful, too. If pain is severe and cannot be controlled you will need to speak to your doctor.
Back pain (simple)
Simple back pain can be relieved by painkillers. Anti-inflammatories like Ibuprofen 400mg three times a day with food appear particularly effective, but must be taken for several days to reach full effectiveness. Be aware, that some patients including Asthmatics and people with previous stomach problems should not take anti-inflammatories. Modern treatment avoids bed rest and tells patient to keep walking a lot to keep your back supple and avoid spasm. Another useful addition is gentle stretching of your back and looking into your posture. Personally, I (Dr Kittel) found the physiotherapist Robin McKenzie’s book “Treat Your Own Back” extremely useful. You should however see a doctor if you cannot pass water, get numbness around your back passage or if the pain goes down below your knee. This can represent a slipped disc and may have to be treated urgently.
Most are caused by viruses and will not respond to antibiotics. You may find steam or a variety of over the counter products helpful for coughs. Please ask the pharmacist for advice. You should see a doctor only if your cough is associated with shortness of breath and / or prolonged fevers (feeling cold and shivery) for more than 4 – 5 days. Coughs usually last 7 – 10 days, but in some cases can last significantly longer. Any cough over 3 weeks however, definitely warrants a doctor’s visit.
Most are caused by viruses and will not respond to antibiotics. There are a variety of over the counter remedies for colds, nasal decongestants often work better and have less side effects than tablets. Always read the label or ask your pharmacist or follow the label for appropriate use of these remedies.
Conjunctivitis = (inflammation / infection of the eyes) can have a variety of causes including allergies, viruses, bacteria, light etc. A simple good start is to bathe eyes using cotton wool with tepid and mildly salted water x 3 per day. Please remember to use fresh cotton wool for each eye. Should problems persist or get worse, please see a health professional. Some pharmacists also prescribe for conjunctivitis.
Simple constipation is caused by inactivity, dehydration and a lack of fibre in your diet. Therefore exercise, plenty of fluids and a regular high fibre cereal for breakfast are good starters for healthy bowels. See a health professional if problems persist. Click here for a simple cereal designed by Doctor Kittel, which will resolve most cases of constipation quickly. Over the counter remedies like Lactulose or Senna are useful if constipation is occasional and short lived, but should not be overused for a prolonged period of time.
Dental and gum problems
Gum problems are often caused by lack of dental hygiene. For inflamed gums use Chlorhexidine Solution (e.g. Corsodyl) x 3 per day, this will improve problems swiftly, and brush your teeth and gums with a soft brush. For dental problems always see a dentist. Click here for addresses for an emergency dentist.
For diarrhoea increase your fluid intake and consider glucose/salt preparations from the pharmacist. Dioralyte is a leading brand, but others are equally good. Also consider sugary drinks like diluted Apple Juice, Blackcurrant Cordial (not the sugar free one) or flat Coke depending on what the patient likes most. Loperamide (i.e. Imodium) can be helpful in adults and a 2mg Tablet can be taken after each episode of acute diarrhoea, but can often cause rebound constipation in overuse. Fever is one of the body’s natural ways of fighting infection. For comfort, consider Paracetamol as directed on the bottle / pack. Blood staining, diarrhoea which is not settling, prolonged fevers with diarrhoea or prolonged diarrhoea without fever as well as a history of recent foreign travel definitely need the input of a doctor.
Most earaches settle within 2 to 3 days with Paracetamol. Many earaches in adults are caused by inflammation of the ear canal and it is not considered harmful to try some Olive Oil ear drops or similar, initially. Only a small number of ear aches are due to infection, most are due to glue ear. Consider seeing a clinician at the surgery if the problem persists, particularly where there is blood or pus from the ear, where the pain is prolonged, single sided or accompanied by fevers.
Flu like illness and fevers
Flu like illness and fevers (high body temperatures) can cause a variety of symptoms. They are commonly associated fatigue, nausea / vomiting and muscle aches. It may be useful to use a fan and sponge down the patient with tepid water. Keep the room at about 18 degrees Celsius. Paracetamol and / or Ibuprofen will both help to lower the temperature and make patients feel a lot better. Influenza (“proper flu”) causes extreme fatigue and high temperatures. Unfortunately there is little health professionals can do and it is advised not to make a doctors appointment in all, but the most severe cases or patients with pre-existing chronic conditions.
Hay fever represents usually a reaction to certain pollen and in most sufferers rarely lasts more than 4-6 weeks per year. Common culprits are birch and grass pollen. There are 3 common hay fever treatments, comprising Antihistamine tablets, nasal sprays and eye drops. Hay fever treatments are all available over the counter and all cheaper than prescription charges. Do not spend large amounts on branded products as non-branded ones are just as effective and much cheaper. Common products are Cetirizine or Loratadine tablets. Start with them at the first sign of symptoms and keep going steadily every day until your symptoms stop. Some patients feel certain tablets are helping only for a certain amount of time until they become weaker, a phenomenon called “Tachyphylaxis”, and sometimes a switching of products within the hay fever season can help. Tablets will, like all medications, not always fully stop but improve symptoms. If symptoms are persistent add nasal sprays and eye drops. Nasal sprays are usually pretty effective in most patients as they are steroid based. However, steroids are not recommended for use in the eyes in hay fever, because of the risk of glaucoma (an increase in eye pressure), and therefore the current eye drops are the weakest link in the triple approach to hay fever. All in all, most hay fever sufferers will feel at least partially relieved using these preparations, but of course the real improvement comes when the season is over.
Insect bites often swell just around the bite and that’s usually an allergic swelling. An easy way of distinguishing allergy from infection is the time from exposure. If its within 24-48 hours the swelling is usually allergic and responds well to over the counter remedies like Piriton antihistamines (read leaflet) or Hydrocortisone cream. If you have scratched a lot and it gets worse after a few days it’s likely to be an infection and you need to see your GP or practice nurse practitioner
There is some scientific evidence that mouth ulcers respond to rinsing with Chlorhexidine Solution x 3 per day. There is no evidence, that other treatments work and there is no point to make a doctor’s appointment in all but the most severe cases.
Sit forward and breathe through mouth. Pinch the lower fleshy end of the nose for 10-20 minutes. Repeat twice more if necessary and if bleeding persists make arrangement to be taken to A&E. Many GPs will cauterise nasal vessels in patients with recurrent nosebleeds, a simple procedure, which will provide lasting relief in most patients. If your doctor does not provide the procedure, he or she can refer you within Bracknell and Ascot CCG to another local practitioner, who will.
Most rashes are harmless. However, any rash or skin change that does not settle may need assessment unless they are clearly belonging to the few rashes mentioned below. If in doubt and a rash has persisted for more than 1 week, contact your doctor. A meningitis rash is very uncommon, but important to be diagnosed correctly and acted upon by calling 999 when it occurs. Find below 6 common rashes, which are usually harmless and or get better themselves make up the majority of new rashes we see in General Practice. Please click on the rashes to get a leaflet on the rash: Non-specific Viral Rash (often towards the end of a viral illness with fevers), Chickenpox (click here for patient under 12 and here for teenagers and adults, but beware of exposure in pregnancy, then contact your doctor), Urticaria (Nettle Rash), Molluscum Contagiosum (Children – Adults), “Slapped Cheek“. If a rash is hot (i.e. infected insect bite) or crusty (i.,e. Impetigo), it also pays to contact your GP or practice nurse practitioner. Good pictures of the conditions above are usually available when you type the condition into Google images.
In any patient with a purple rash which does not disappear under a glass like the rash above, you must call 999 immediately, even if the patient appears well. If Antibiotics are given straight away you may have saved a life. Rashes that disappear with a glass are mostly harmless.
Most are caused by viruses and will not respond to antibiotics. They start to improve within 3 to 5 days. Keep the throat moist with fluids or lozenges and take Paracetamol if necessary. You may find ice lollies, jelly, hot lemon and honey drinks help. In tonsillitis you don’t necessarily have to see a doctor with tonsillitis as it is often viral however with bacterial tonsillitis treatment with antibiotics is useful to avoid a Quinsy and you would need to see a doctor for this treatment. There are 4 cardinal signs to distinguish tonsillitis from a normal sore throat. They are called “Centor Signs” and are: 1) Fevers, 2) Red Swollen Tonsils with exudates (see picture), 3) swollen neck glands and 4) the absence of a cough. If a cough is present, the sore throat is usually viral. Other signs of a tonsillitis are a sickly sweet smell from the mouth of the patient and a “guttural” throaty speech as well as drooling in children (weak sign as its also common in teething and often normal in infancy).
The picture above shows a sore throat with acute tonsillitis, which needs treatment with antibiotics. Note the dirty exudates on the large red tonsils. The patient will almost certainly have fevers, a very throaty speech and a bad smell from the mouth
Warts / Verrucas
Where appropriate consider wart treatments available over the counter like Salactol Paint. Be aware you need to treat for quite some time i.e. up to 12 weeks depending on area of the body. Treat once daily and stop for a day or two should surrounding tissues get too irritated. Almost all warts respond to this treatment. Failure to respond may indicate a different skin lesion and would need further assessment. Be aware, that currently some wart treatments are considered “low priority” and are not available on the NHS. For further information click here.
Disclaimer: Advice given on this website is general and does not apply to all patients. Bracknell & Ascot CCG cannot accept any responsibility whatsoever for any illness and injury as a result of advice given via it’s website. You may have reasons why medication recommended in the health advice is not suitable for you and this may invalidate the advice given. Always follow instructions given with the medication you purchase.
Author – Dr M Kittel and Dr M Nouveloni – Jan 2013