Health Info

Acid reflux is known by a number of names including GORD (gastro-oesophageal reflux disease), reflux, dyspepsia, and heartburn. This condition is caused by what happens to your food and drink after you have eaten.

When you eat or drink anything, gravity and muscles allow the food to travel down the tube-like oesophagus to the stomach. Once in the stomach, the contents are normally prevented from going back upwards again by a valve or sphincter at the join between these two parts of the digestive system.

When this valve becomes loose or is prevented from tightening around the top of the stomach contents can travel back up the oesophagus to the mouth again. This results in an acid taste in the mouth from the stomach acids, and vomit from the partially digested food and fluids.

Certain foods, medicines and medical conditions can make this worse, either temporarily or permanently, and may result in damage to the oesophagus if not treated effectively.

People at risk of acid reflux may find that smoking, alcohol, rich or spicy food may aggravate this condition. It is not uncommon for pregnant women to develop acid reflux as the size of the baby may put pressure on the stomach and not allow the usual amount of food or liquid to be taken in. Other causes of acid reflux include hiatus hernia, and being overweight or stressed. Medications for blood pressure, asthma, depression, and insomnia may also worsen or cause acid reflux.

Symptoms of acid reflux, apart from the metallic or acid taste in the mouth and occasional small amounts of vomit described earlier may include tightness or burning in the chest, feelings of nausea, difficulty swallowing and a persistent cough.
Often the condition is worse at night when lying down, or after a large, rich or spicy meal, or when feeling tired or stressed.

As some of the symptoms of acid reflux may also be symptoms of more serious conditions it is important to seek help whenever any of these symptoms occur. Your community pharmacist will be able to help with determining if you are suffering from a serious condition requiring prompt referral to your doctor, or with treatment or advice to help you treat, manage, prevent or lessen the effects of this condition which can cause severe discomfort and distress to those suffering from it.

It is not uncommon for patients with severe symptoms of heartburn to confuse the symptoms of their acid reflux with angina, or chest pain, so if you or anyone around you complain of sudden severe crushing pain in their chest or arm then do not delay and call the ambulance immediately.

For those that already have acid reflux, it is very important that they use effective treatment as damage to the oesophagus can cause other more serious conditions if not treated effectively. It is best not to put up with stomach discomfort, but to seek help and advice from your community pharmacist, who has many treatments available for purchase over the counter to manage this condition.

Is the skin between your toes peeling? Do your feet have a rather whiffy aroma? If so, you may well have athletes foot.

Although the experts are divided as to whether athletes foot (Tinea pedis) is worse during the heat of summer - or the cold winter months when your feet are couped up in shoes all day - either way this condition can spread like wildfire through your household unless treated immediately.

Athlete’s foot is caused by a group of fungi called dermatophyte fungi that grow in warm moist environments and can cause infection in the skin. It spreads easily through direct skin-to-skin contact or indirectly through contact with infected surfaces – like sharing towels, shoes and bath mats. It can also be caught by walking barefoot in warm damp areas like communal showers, gyms, swimming pools or changing rooms. Secondary infection can occur if skin is split, bleeding, or blistered.

Athlete’s foot commonly affects the skin between the toes – particularly between the fourth and small toe. The skin may appear soft, white and peeling but can also be red, itchy and scaly. It can also sometimes spread to the sole of the foot where it appears dry, cracked and scaly. Other symptoms include itching, burning, stinging, small blisters, fissures (splitting) and bleeding.

The good news is that athletes foot is easily treated by using creams and powders.

Anti-fungal creams work by preventing fungi from multiplying (fungi-static), or by killing fungi directly (fungi-cidal). Fungi-static antifungal creams need to be applied for approximately two weeks after the infection has cleared, while fungi-cidal antifungal creams can be stopped once the infection has cleared.

Anti-fungal powders are good for dusting in shoes or socks to kill residual fungal spores and prevent reoccurrence, while corticosteroid creams help reduce itch and inflammation. Corticosteroid creams must be applied sparingly and used strictly according to product recommendations and the advice from your community pharmacist.

It is a good idea to talk to your community pharmacist for advice on using these products. Some products contain both an anti-fungal and a corticosteroid so you will need to ensure treatment is not duplicated.

Your community pharmacist can also advise you on making lifestyle changes so that you can minimise the risk of getting athletes foot in the future.

The sting of a bee or wasp is a defence mechanism – it is to protect them from us. The sting is poisonous and painful, and can cause severe reactions. Most people get a painful sensation at the time of a sting, and the area swells and reddens.

Some people are particularly sensitive or allergic to stings. They have a life threatening reaction called anaphylaxis which results in swelling of the face, difficulty breathing and a rash over their entire body, not just in the region of the sting. This is a medical emergency and must be treated as soon as possible so call the ambulance. People that are allergic often carry medication to treat this reaction, and usually have identification bracelets to alert those around them of this.

Those that are not allergic still need to remove the sting as soon as possible. Try not to squeeze the sting as it may continue to push in venom, so use a sharp edge to scrape it out such as a credit card, rather than using tweezers.

Clean and cool the area using cool water and cloths or a cold pack to ease the pain and swelling over the area of the sting. Generally bee and wasp stings do not cause intense itching, but mild steroid creams are helpful for the swelling and inflammation around the sting. Pain relieving and antihistamine medicines are also helpful, particularly if there are multiple stings.

Some stinging insects are attracted to bright coloured clothing and perfumes so try to avoid these if entering an area where there is a possibility of being stung. It is also helpful to remove any beehives or wasp nests nearby, and covering up exposed areas of skin with clothing, gloves, socks and hats if your are entering areas where you know there will be bees and wasps.

Your community pharmacist is able to advise you of the correct treatment for bee and wasp stings, and can help you lessen the possibility of stings in the future. If anyone in your family is allergic to stings then your pharmacist can ensure that you have the right emergency medicine and treatment options to lessen the possibility of life threatening stings.

A blister is a raised area of skin that is filled with a clear liquid, or occasionally blood, over which the skin is intact. They form when that area has been damaged by pressure, chemicals that have been applied to the area, burns, insect bites, allergies, fungal or viral infections.

If no further damage occurs to that area then the skin over the fluid stays intact and unbroken and the fluid is gradually re-absorbed back into the surrounding tissue.

Blisters formed from pressure often occur on the feet, from new footwear or after a sporting activity, and from changing from casual summer shoes to more formal, constricting footwear. Blisters also occur from overuse, such as on the hands after repetitive actions with tools and devices, like from the handle of a spade after digging in the garden.

If the blister has been caused by friction or pressure, try to relieve the pressure by using padded dressings and bandages and soft footwear or protective gloves when undertaking activities that may cause further damage.

When the skin has been damaged by a burn or from irritant substances, then it is important to cool the area or rinse away the irritant with cool water – if possible hold the blistered area under a running cold water tap, or use wet towels over the burned or damaged area, changing them frequently to ensure the irritant has been removed and the area cooled.

If blisters are as a result of an infection, bite or allergy, then consult your community pharmacist. They will be able to give you specific advice to treat the underlying condition and to prevent further blisters occurring.

The most important treatment for a blister is to avoid breaking the skin over the blister. The fluid that is contained in the blister will disappear over the next few days and no infection should arise if the skin surface is not further damaged. These blisters are generally only painful when pressure is applied to them.

If the blister breaks then there is a risk of infection developing. They are also generally much more painful and take longer to heal. It is important to gently clean and cover the area with a clean dressing, and observe the blister and surrounding skin for any signs of redness, blood or infection developing.

If you have an area that is prone to developing blisters then you can use protective dressings that pad and protect the area to prevent blisters occurring. Your community pharmacy has a range of dressings that are specifically designed to speed healing, as well as to prevent, protect and treat blisters.

In order to prevent blisters and other skin damage remember to protect the skin with socks, soft comfortable footwear that is neither too large or too tight, and use gloves to protect your hands from friction and pressure damage, as well as from irritant chemicals.

Your community pharmacist is able to give you help and advice if you need to seek further help to treat the damaged or infected areas of skin affected by blisters.

Chilblains are burning red areas that occur on the end of fingers, toes and other areas of the skin that have been exposed to the cold. They generally occur a few hours after the exposure so you may not always recognise what is causing the itching and burning that usually always follows the damage from the cold.

When the extremities get cold, the blood vessels in these areas become smaller, and when the area warms up again, some of the blood is thought to ‘leak out’ into the surrounding areas causing pain, swelling and itching.

Unfortunately when a cold snap occurs, you may be unprepared for the temperature change, and not have suitable protection for the exposed areas of skin, starting the chilblain cycle.

Some people are more likely to develop chilblains, and they should prepare for the possibility of weather changes causing circulation problems, and be prepared with gloves, scarves and hats to keep them warm. This should prevent the blood vessels from tightening due to the cold, and then from rapidly opening up again, causing the damage resulting in chilblains.

Once exposed skin has chilled it is best to warm the area gradually, with warm water rather than hot, and gently rubbing or massage with simple moisturiser and emollients to prevent sudden temperature change. Remember to cover the ear lobes if out in the chilly weather, and after exposure gently rub them with a moisturiser as well.

Once a chilblain has developed, the priority is to prevent the skin from breaking and infection occurring as well. This is why it is important to prevent further exposure to the cold, so keep on covering the affected areas whenever the temperature drops rapidly, or when going outdoors in chilly weather. It may take up to ten days for chilblains to heal, so you will need to persevere with any treatment that you are advised to use.

Your community pharmacist can advise you as to how to treat chilblains, help to heal the damage and how to prevent them occurring in the future. If you have suffered from chilblains in the past then go and see your pharmacist to prevent repeated occurrences of this painful condition.

There has been concern expressed about the safety and usefulness of treating coughs and colds in children. Most cough and cold treatments are no longer regarded as being suitable for children under the age of six; but that is little comfort when your child is unwell and you want to ease their symptoms so they and the family can recover.

Children get colds, often up to ten times a year, and there is no specific treatment for the viruses that cause these infections, but there are things that you can do that will help to relieve some of the symptoms in your children.

Ensure that your child is well hydrated, keep giving them whatever fluids they normally drink, and make sure that water and other cool fluids are easily available if they are not breastfed. Regular milk and diluted fruit juices are suitable, or you could offer oral rehydration fluids. Continue to offer breast milk, and supplementary water such if your child is still breast fed.

Children older than 12 months old may be given a little honey to sooth a dry cough or scratchy throat, if they have had honey before with no ill effects. The very young are advised not to be given honey, so cool soothing foods such as ice blocks made from diluted juice, yoghurt ice cream and custards may be used instead.

Nasal and chest congestion causes considerable distress as the nasal and air passages in children are smaller and easily blocked up by dried secretions. This is particularly important in babies, as they breathe through their nose not their mouth, so the air flow must not be impeded by gummy nasal congestion. Saline drops and sprays for older children are available and will moisturise and soothe irritated nasal passages and help to flush out the nostrils.

Treating fever and temperature with paracetamol is commonly advised. Ensure that the dose you use is correct for the age and weight of your child, that they are not given a dose any more than four times in any 24 hour period, and no closer than every four hours. It is helpful to store an accurate medicine measure with the paracetamol, so that you can measure out a correct dose to treat your child when they and you are tired and distressed, especially in the middle of the night.

If your child is unable to be soothed by these treatments, if they are weak, their breath is whistling or wheezy, if they are tugging at their ear or their fever is not responding to treatment then see a doctor immediately. Children get very sick very quickly, and they appear to recover quickly as well.

If you are concerned about what to do if you or your children get a cold or of any symptoms that they may have, your community pharmacist can advise you of what is suitable, how to lessen any symptoms and the correct doses of any treatments that are appropriate for you and your family.

Insomnia is the term used to describe either difficulty falling asleep when going to bed, or staying awake during the night. Many people, especially shift workers, suffer from sleep disturbances when they change their sleeping pattern after moving from night shift to afternoon or day shifts and vice versa.

Insomnia falls into two usual categories - either chronic or ongoing inability to sleep through the night, or the occasional or episodic pattern of sleepless nights. Some of us manage to have full productive lives with less than six hours sleep each night; famous examples include Winston Churchill and Margaret Thatcher. For the rest of us, after a night of poor sleep we feel exhausted and not able to function at a peak level of achievement.

Insomnia is most commonly suffered by new parents - poor sleep patterns become a way of life for the first few months of their child’s life as they struggle to get four or more uninterrupted hours rest each night. Others may suffer from insomnia when they are over-stimulated, by stress, too much alcohol or caffeine, drugs such as diet medications or cold remedies, noise or changes to the sleeping environment.

Sleeping well is a habit. Disturbing that habit by going to bed and not being prepared for sleep by activities, such as using electronic devices, can change your ability to fall asleep or to stay asleep. As you age the urge to urinate tends to wake many of us, and having difficulty falling asleep after one of the many trips to the toilet can impact on the quality and length of sleep achieved each evening, leading to sleep deficits.

Before appropriate treatment for insomnia can be determined, it is important to establish what is your usual sleep pattern or needs. Not all of us need eight or nine hours sleep as we age. First of all talk to your pharmacist. They can help to determine if there has been any change that may have caused a change in your ability to sleep.

Sleep hygiene is about undertaking activities that should help you fall asleep; either on first going to bed, or to fall asleep more easily after being woken. Establishing a pattern of only going to bed when tired and ready for sleep, and only trying to go to sleep when you get into bed, helps build a pattern of sleep preparation. Remove stimulants, such as bright bedroom lights, televisions, cell-phones and computers from the bedroom, or ensure they will not cause you to wake up by turning them off. It is often helpful to remove clocks as repeated checking of how long you have taken to fall asleep generally worsens the anxiety about being able to sleep.

If this is not successful in allowing you to fall asleep within about 30 minutes of going to bed, then it is helpful to get up and do something in another room to stop you worrying about being unable to sleep, and return to bed after a period of quiet reading, de-stressing or relaxing exercises, such as yoga.

If these do not assist in helping to normalise your sleep patterns then short term use of medicines, such as sedating antihistamines, may be helpful for a day or two to break the habit of sleeplessness. These sedating medicines should only be used if safe for you and this is best discussed with your pharmacist or referred on to your doctor, especially if the sleeplessness is caused by mild depression or anxiety.

It is important to realise that alcohol is not helpful in assisting sleep problems. Although it does sedate you, it can also cause insomnia, so is best avoided if troubled by sleep disturbances. Talk to your community pharmacist for help in getting a good night’s rest, as they can assist with safe effective treatments as well as advice to deal with this troubling disturbance to your enjoyment of life.

Burns are caused when your skin comes into contact with something too hot or too cold causing damage to one or more layers of skin. They may be caused by liquids (generally called scalds) or by being exposed to radiation, such as sunburn, as well as by electricity or chemicals.

The type of burn referred to as a minor burn generally only affects the top layer of skin and may be effectively treated without needing to see your doctor, provided the area affected is not large and the skin is not broken.

Minor burns are painful, they cause reddening and swelling of the affected area, but generally heal within a week, with the correct treatment.

The first think you need to do when the skin is burned is to cool the skin (or in the case of a freezer burn, to gently return the area to body temperature), so use tepid, not icy cold water, for at least ten minutes, to cool the area affected as soon as possible after the injury occurs. A cool bath or shower is also effective to return the area to body temperature and limit the damage to surrounding tissue.

Do not use butter, oil or any greasy substance to soothe the area as this will keep the heat in and make it worse. After two or three hours and the affected area has cooled, a moisturiser could be used if the skin is not broken. The burn can also then be covered with a clean dry bandage or cloth, if on arms, legs, hands or feet. Minor burns to the body may be covered with light cool clothing. Small, minor burns to the face should be left uncovered if the skin is not broken so that further cool compresses may be applied if needed.

If the burn is painful, then taking a mild pain reliever such as paracetamol is often helpful, ensuring that the correct dose is given for that person.

If blisters develop then do not break the blister, but consult your community pharmacist, who will be able to advise you on either an appropriate treatment or advice, or may refer you to your doctor if required.

It is helpful to have simple first aid preparations available to treat minor burns and scalds on hand at all times, particularly in areas where burns often occur; such as the kitchen or when on holiday in the sun. Consult your community pharmacist for the essential burn preparations to have in your first aid kit.

A mouth ulcer is a painful pale coloured sore on the moist inner skin of the mouth. They make eating and tooth brushing difficult, as food and the brush scrapes against the exposed surface causing pain and discomfort.

Generally mouth ulcers are small round sores with a raised edge, but they may become as large as a 10 cent piece, or occur in clusters or in several places in the mouth.

Some mouth ulcers are caused by injuries such as from dental work, biting the inside of the mouth, rough brushing or sharp food damaging the lining of the mouth. Other causes include stress, vitamin B12 and iron deficiency, reactions to certain foods, hormone changes in women, from more serious conditions such as Crohn’s disease and, rarely, from mouth cancer.

The best way to prevent mouth ulcers is to avoid the causes – gently cleaning the teeth with a soft toothbrush, a healthy diet, avoiding stress and other triggers. However avoiding all causes is often not possible, and the first treatment is to ensure good oral hygiene.

Change your toothbrush regularly, use mouthwash or hot salty water to rinse the mouth after eating to remove any debris and ensure the oral cavity is as healthy as possible. Try to eat foods that are not too spicy or rough in texture, to ensure that food is not further damaging the ulcerous area.

Products such gels that ease the pain are available from your pharmacy, as well as pastes that stick to the ulcer and protect it from rough tooth edges and further damage, allowing the area underneath to heal.

Mouth ulcers that have not responded to treatment, are recurrent, are at the back of the mouth, or which change appearance need to be checked out. Your community pharmacist will be able to give you appropriate advice and treatment, or refer you to further medical or dental attention to deal with your mouth ulcer.

Tinnitus is the name for ringing in the ears or hearing sounds in your head. It may be continuous or it may come and go. It is only heard by the sufferer and not by those around them. Usually it takes the form of a swishing or whining sound, but may vary in pitch and intensity, and in one or both ears. Whatever form the sounds take, they are distressing and may affect your ability to hear other sounds and otherwise live a normal life.

The sounds may arise from damage to the structures or nerves of the inner ear, beyond the ear drum. It may also be caused by substances in the ear canal, such as fluid, excessive ear wax or other obstructions, and removal of these substances may ease the condition. Other causes of tinnitus include aspirin or other medicines in excessive doses, exposure to persistent loud noises or other conditions that affect the inner ear, such as dental or sinus conditions.

The elderly are more at risk of tinnitus, as the nerves become less able to recover from any damage, and so are more likely to be affected by hearing distressing noises and other hearing disorders.

Treatments for tinnitus depend on the cause, if known. For many people the cause is unknown, and treatment for them is more difficult. The first step is to determine if there is any obstruction or substance in the outer ear causing the problem. If there is, then removal of the irritant will generally ease the sounds and cure the condition.

Other people that have tinnitus caused by dental problems need to address this with dental treatment or examination by a dentist, including X-rays to see if sinus or dental infections are causing pressure or the disturbance to the inner ear. Similarly it is also important to exclude other medical conditions that may cause tinnitus, so consult a doctor to check if this is the case.

When there is damage to the nerves or structures of the inner ear, or where the cause is unknown, treatment options may not always be successful in curing tinnitus. Other treatments to deal with the stress of living with constant sounds disturbing their activities of daily living may be helping in easing, if not necessarily curing the condition.

The least invasive treatments include counselling and cognitive behavioural therapy to change the way that you react to the sounds. Other treatments include sound generators, hearing aids, or some medications that dampen down nerve endings and also help with the anxiety and depression that may accompany this condition.

If you or any of your family members or friends complain of hearing persistent sounds then talk to your community pharmacist. They can check out likely problems and causes, and give you products and advice to help in the early stages of this condition. They can also refer you to appropriate health professionals to help identify the cause of the tinnitus, and help you to limit the effect of this condition on your life and of those around you.

Warts are caused by a virus that affects the cells of the surface of the skin and causes rough lumps to grow either out of or into the skin and tissue underneath the site of infection.

There are several different types of wart, and they are grouped into three main types, but all are caused by direct contact with someone else with the wart infection.

A planar wart or verruca is found on the feet, and is usually transferred from person to person in places such as changing rooms and showers where minute damage to the surface of the skin can allow the virus to enter the sole of the foot. They cause considerable pain and discomfort when standing or walking.

Common warts may occur anywhere and often develop into clusters over time. They are frequently transferred between children and teenagers and are not usually harmful but may cause some discomfort if they are subjected to pressure or frequent injury. Usually common warts are found on fingers, knees and the back of the hands, and they form small raised lumps that can develop into cauliflower-like growths.

Genital warts are spread by sexual contact, they occur around the sexual organs and may also develop into clusters but they do not usually cause any pain. Any warts, lumps or changes to the genital area should be reported to a doctor for treatment as soon as they are noticed.

Most other warts are easily treated with preparations available from your community pharmacy. Wart treatments available from your pharmacy are either sprays which freeze the wart or lotions that you apply onto the wart to burn it off over a period of time. Successful removal of warts requires repeated treatment as the wart viruses are difficult to treat so be prepared to persevere in order to prevent the wart growing back.

It is important when treating warts to protect the skin around the wart as it may be damaged by the treatment you may use. Your community pharmacist can advise you of the most suitable treatment to remove warts effectively and can advise you about protecting the skin around treated warts in order to prevent any damage to the skin.

Speak to your pharmacist - they know how to help you treat minor skin conditions and infections such as warts.

Worms are one of the most common conditions that children catch, occasionally from pets, but usually from themselves, or other infected people. There are several types of worms that can affect humans, but in New Zealand the usual culprit is the threadworm.

You catch worms by eating the worm’s eggs which hatch in the intestines to produce the worm. This worm will then travel out the intestines and lay further eggs around the anus, causing itching. If the area is scratched the eggs may lodge under the fingernails. They are then spread by touching food or other people, infecting either themselves again or others.

You can detect if your child has worms if they have the thread-like worms in their poo or suffer from an itching bottom, particularly at night, where the small eggs may be seen.

Treating worms is generally simple. Most people are treated successfully by preparations available from your community pharmacist. However, not all worm preparations are safe for all, so you need to seek advice about whether worm treatments are suitable for everyone in your family. It is usual to treat all family members, in case the infection has spread beyond the affected person. If you cannot be treated for any reason, then you should be careful to practice good hygiene, keeping fingernails short and well-scrubbed, especially after touching an infected person or their belongings. Affected skin, particularly around the bottom, can be soothed by protective creams used for nappy rash.

If you believe that you or anyone in your family may have worms, consult your community pharmacist for treatments and advice on how to prevent reinfection.

If you have been travelling to other countries, and suspect a worm infection, or have been feeling tired or are suffering from Diarrhoea, you may have been infected with some other more sinister parasite that will need an alternative treatment in order to eradicate the infection. Your community pharmacist will be able to supply you with the advice you need to address this.