Tonsillitis
Tonsillitis is a common childhood illness but teenagers and adults can get it too. It usually goes away on its own after a few days.
Tonsillitis can feel like a bad cold or flu. The tonsils at the back of your throat will be red and swollen.
The main symptoms in children and adults are:
• a sore throat
• difficulty swallowing
• hoarse or no voice
• a high temperature of 38C or above
• coughing
• headache
• feeling sick
• earache
• feeling tired
Sometimes the symptoms can be more severe and include:
• swollen painful glands in your neck – feels like a lump on the side of your neck
• white pus-filled spots on your tonsils at the back of your throat
• bad breath
How long tonsillitis lasts
Symptoms will usually go away after 3 to 4 days. Tonsillitis isn't contagious but the infections that cause it are (for example, colds and flu).
To stop these infections from spreading:
• stay off work or keep your child at home until you or your child feel better
• use tissues when you cough or sneeze and throw them away after
• wash your hands after coughing or sneezing
How to treat tonsillitis yourself
Tonsillitis usually has to run its course.
To help ease the symptoms:
• get plenty of rest
• drink cool drinks to soothe the throat
• take paracetamol or ibuprofen (don't give aspirin to children under 16)
• gargle with warm salty water (children shouldn't try this)
Your Pharmacy can help with tonsillitis. Speak to a pharmacist about tonsillitis. They can give advice and suggest treatments to ease a sore throat like:
• lozenges
• throat sprays
• antiseptic solutions
Non-urgent advice: See a GP if:
• you have white pus-filled spots on the tonsils at the back of your throat
• the sore throat is so painful it's difficult to eat or drink
• the symptoms don't go away after 4 days
Your doctor can usually tell its tonsillitis by asking about your symptoms and looking at the back of your throat. Sometimes they might:
• wipe a cotton bud at the back of your throat to test for bacteria (throat swab)
• organise a blood test to rule out glandular fever (if your symptoms are severe or won't go away)
Usually you'll get any test results back within a couple of days.
Treatment from a GP
Treatment will depend on what caused your tonsillitis:
• a virus (viral tonsillitis), which most children and adults have – this type has to run its course and antibiotics won't help
• bacteria (bacterial tonsillitis) – your GP may prescribe antibiotics
Usually your GP will have to wait for the test results to tell which type you have. It's very rare that someone needs to have their tonsils taken out. This is usually only the case if you have severe tonsillitis that keeps coming back.
Complications with tonsillitis (quinsy)
Complications with tonsillitis are very rare. If they happen they mostly affect young children aged 2 to 4.
Sometimes you can get a pocket filled with pus (abscess) between your tonsils and the wall of your throat. This is called quinsy.
Urgent advice: See a GP urgently or go to A&E if you have:
• a severe sore throat that quickly gets worse
• swelling inside the mouth and throat
• difficulty speaking
• difficulty swallowing
• difficulty breathing
• difficulty opening your mouth
These are signs of quinsy.
Threadworms, Information Prescription
Treating threadworms
To successfully treat threadworms, all household members must be treated, even if they have no symptoms.
The aim of treatment is to get rid of the threadworms and prevent re-infection. To do this, you can either:
• Follow strict hygiene measures (see below) for six weeks.
• Take medication and follow strict hygiene measures for two weeks.
Some treatments are available from your local pharmacy without prescription. Always follow the manufacturer’s instructions because they may not be suitable for everyone.
Visit your GP if you think that you have threadworms and you:
• are pregnant or breastfeeding
• your child has threadworms and they are under two years old
See below for treatment advice for pregnant and breastfeeding women and babies.
Hygiene method
Strict hygiene measures can be used to clear up a threadworm infection and reduce the likelihood of re-infection. The life span of threadworms is approximately six weeks, so it's important that the hygiene methods are followed for six weeks. Everyone in the household must follow the advice outlined below.
• Wash all night clothes, bed linen, towels and soft toys when you are first diagnosed. This can be done at normal temperatures but make sure that the washing is well rinsed.
• Thoroughly vacuum and dust the whole house, paying particular attention to the bedrooms. Continue to vacuum regularly and thoroughly.
• Carefully clean the bathroom and kitchen by damp-dusting surfaces and washing the cloth frequently in hot water. Continue to clean bathroom and kitchen surfaces regularly and thoroughly.
• Avoid shaking any material that may be contaminated with eggs, such as clothing or bed sheets. This will help prevent eggs being transferred to other surfaces.
• Don't eat food in the bedroom, because you may end up swallowing eggs that have been shaken off the bedclothes.
• Keep your fingernails short. Encourage other members of your household to do the same.
• Discourage nail-biting and sucking fingers. In particular, make sure that children don't suck their thumb.
• Wash your hands frequently and scrub under your fingernails, particularly before eating, after going to the toilet and before and after changing your baby's nappy.
• Wear close-fitting underwear at night and change your underwear every morning.
• Bath or shower regularly, particularly first thing in the morning. Make sure that you clean around your anus and vagina to remove any eggs.
• Ensure that everyone in your household has their own face flannel and towel. Don't share towels.
• Keep toothbrushes in a closed cupboard and rinse them thoroughly before use. Children can easily pick up another threadworm infection from friends or at school, so maintaining good hygiene may help prevent another outbreak.
Medication
Medication can be used to treat threadworms. It should be taken by everyone in the household.
The risk of transmission between household members is high (around 75%), which means that everyone in the household is likely to be infected, even if they don't have any symptoms.
Mebendazole and piperazine are two medications that are commonly used to treat threadworm infections.
Mebendazole
Mebendazole works by preventing the threadworms from being able to absorb glucose, which means that they will die within a few days. Mebendazole is the preferred treatment for children over two years old. It can be bought over the counter from your local pharmacy or prescribed by your GP and is available as a chewable tablet or as a liquid.
As threadworm re-infections are very common, a second dose of mebendazole may be prescribed to be taken after two weeks. You should follow the dosage information on the label or in the patient information leaflet that comes with the medicine. In rare cases, mebendazole can cause abdominal pain or diarrhoea, particularly if the threadworm infection is severe.
Piperazine
Piperazine paralyses the threadworms until they are passed naturally out of the bowel. It is combined with a medication called senna, which has a laxative effect to expel the worms more quickly.
Piperazine and senna usually come in a sachet of powder, which you mix with a small amount of milk or water before drinking. Piperazine can be used to treat children who are between the ages of three months and two years old. As re-infection is very common, a second dose may be taken after two weeks. Dosage information will be provided on the label or in the patient information leaflet that comes with piperazine.
Piperazine is not recommended if you have epilepsy (a condition that causes seizures) or problems with your liver or kidneys.
Mebendazole and piperazine are 90%-100% effective at killing the threadworms, but they don't kill the eggs. Therefore, the hygiene measures outlined above should be followed for two weeks after treatment.
Visit your GP if the infection continues after treatment. They may recommend that you begin a second course of medication.
Pregnancy and breastfeeding
If you are pregnant or breastfeeding, medication is usually not recommended. To treat threadworms, use the hygiene method. See your GP if you are more than three months pregnant or if you are breastfeeding and you experience problems treating a threadworm infection using only the hygiene method. In certain circumstances, your GP may consider prescribing medication.
Babies under three months old
Medication is not recommended for babies under three months old who have a threadworm infection. Instead, follow the hygiene method. Make sure that you wash your baby’s bottom gently but thoroughly every time you change their nappy. Also wash your hands thoroughly before and after changing their nappy.
Scabies - information prescription
Treating scabies
See your GP immediately if you have scabies and you haven't had a previous infection. Delaying treatment places other people at risk. As other more serious skin conditions can sometimes cause similar symptoms to the symptoms of scabies, your GP will need to rule these out.
If you have scabies, your partner will also need to be treated regardless of whether or not they have any symptoms. This is because it's highly likely that scabies will have been transmitted through close bodily contact, such as during sex.
To reduce the risk of reinfection, avoid having sex and other forms of prolonged close bodily contact, such as holding hands, until both you and your partner have completed the full course of treatment.
Lotions and creams
Lotions and creams are commonly used to treat scabies. Your GP, pharmacist or nurse will be able to advise you about which treatment to use.
Applying the cream or lotion:
To prevent reinfection, all members of your household and any close contacts, including recent sexual partners (see diagnosing scabies for further details), should be treated at the same time as you, even if they don't have any symptoms.
The cream or lotion should be applied to the skin of all of your body, except your head. Before you apply it, make sure your skin is cool and dry. Don't apply it after having a hot bath. If you apply it when your body is hot, it will quickly be absorbed into your skin and won't remain on the area where the scabies burrows are.
You should also follow the advice outlined below.
• Read the patient leaflet that comes with the cream or lotion for details of where to apply it. Some products need to be applied to the whole body, including the scalp and face, whereas others must only be applied from the neck down.
• Pay particular attention to difficult-to-reach areas, such as your back, the soles of your feet, in between your fingers and toes, under fingernails, and on your genitals.
• Use a cotton bud or old toothbrush to apply the treatment under fingernails and toenails. Put the cotton bud or toothbrush in a bag and throw it away afterwards.
• Leave the treatment on your skin for 8 to 24 hours (depending on the preparation used) before washing it off thoroughly. Follow the manufacturer's instructions regarding how long to leave the cream or lotion on for.
• Reapply the cream or lotion immediately to any areas of skin that are washed during the period of application.
• Wash bed linen, nightwear and towels after the first application.
• Repeat the treatment process seven days after the first application to ensure it's successful. The second application will ensure any mites hatched from existing eggs are killed.
Contact your GP if the itching hasn't improved after two weeks of treatment and you notice new burrows on your skin.
It can take a month after treatment for the general itching to subside completely, and longer for the lumpy genital lesions to resolve. Your GP may recommend repeating the treatment or they may prescribe a different lotion.
You should also speak to your GP or pharmacist if you experience any persistent side effects.
Infection control
On the day you first apply the cream or lotion, you should wash all bed linen, nightwear and towels at a temperature above 50C (122F). If you're unable to wash certain items, place them in a plastic bag for at least 72 hours. After this time, the scabies mites will have died.
In cases of crusted scabies, you should clean the floors in your house and thoroughly vacuum your carpets and furniture, including the armchairs and sofa.
If you've been diagnosed with scabies, avoid close and prolonged physical contact with others until you've applied the cream or lotion. You should also avoid close contact with other members of your household until their treatment has been completed. Children and adults can return to school or work after the first treatment has been completed.
Itchiness
Your GP should be able to prescribe treatments, such as a mild steroid cream, to reduce the itchiness. Menthol cream or gel, available from pharmacies without a prescription, may also help relieve itchy skin.
Oral sedative antihistamines are also available from your local pharmacy and can be used to control itching and help you get a better night's sleep. As this type of antihistamine can cause drowsiness, you should avoid driving or operating heavy machinery if you're affected in this way.
Non-sedating antihistamines don't help relieve the itching of scabies. Check with your GP or pharmacist if you're unsure.
You may continue to experience itchiness for a couple of weeks after your treatment has been completed. This is because your immune system will still be reacting to the presence of dead mites and their droppings.
Visit your GP if you're still experiencing itchiness six weeks after completing your treatment.
Pregnancy Planning and Diabetes
Oral thrush (candida) in babies and toddlers
Your baby or child has been diagnosed with oral thrush. Oral thrush causes white patches around their mouth that won't easily rub off or are red, raw or bleed.
Thrush is a fungal infection caused by a yeast called candida albicans. Oral thrush in babies and children means that the infection is in their mouth. Thrush causes creamy white lesions, usually on your baby’s tongue or inner cheeks. Sometimes ora thrush may spread to the roof of your baby’s mouth, gums or tonsils, or the back of the throat. An oral thrush infection can also cause a pimply red rash in the nappy area.
Not all babies with oral thrush will have symptoms.
If your child refuses to eat, or baby refuses to feed, check their mouth for any white patches. Try to wipe them off with a clean handkerchief.
Your child probably has oral thrush if any of the following are true:
• you can't easily rub the patches off
• the patches are red or raw underneath
• the patches bleed
Causes
Healthy people have this yeast in their mouths and intestines. It doesn't normally cause problems. But in babies it can overgrow and lead to an infection. This is because a baby's immune system has not developed enough.
An overgrowth of yeast can also happen if your child has been on antibiotics. This is because antibiotics can kill "good" bacteria that keep candida from growing.
Treatment
If your baby needs treatment, the GP will prescribe a liquid antifungal medication. This will kill the fungus in your baby's mouth. If the infection has not cleared after 7 days, contact us again. We may continue treatment for a further 7 days. Or they may prescribe another antifungal medicine.
If your baby has oral thrush and you are breastfeeding, speak to your GP. You could get nipple thrush but your GP can prescribe cream to treat or prevent this.
If your child has oral thrush:
• feed them mild foods
• keep their hands clean so that the infection does not spread
• sterilise any dummies regularly, as well as any toys they put in their mouth, such as teething rings
• sterilise any bottles and other feeding equipment regularly, especially the teats
• wash your hands after changing nappies
Gradually introducing flax or linseeds into your diet
How to Take Your Antiobiotics
What are antibiotics?
Antibiotics are medicines used to treat infections caused by bacteria. Antibiotics work by killing bacteria. If you are having an operation for example a hip replacement or bowel surgery, you will be prescribed antibiotics at the time of surgery to prevent an infection.
Antibiotics do not work against infections caused by viruses such as common colds, flu, most coughs or sore throats.
How do I take my antibiotics?
Antibiotics are usually tablets to be swallowed. However, sometimes they are given as drops, lotion or ointment to the skin, eye or ear. Your doctor, nurse or pharmacist will tell you how and when to take your antibiotics. If you are not sure, ask. Please use the antibiotics in the way they have been prescribed, and take them at the times that your doctor or pharmacist tells you. Antibiotics can also be given by injection into a vein. This is usually in people with severe infections or in people about to have surgery.
If you have antibiotics that you have not used for any reason, ask your pharmacist to dispose of them.
Never give your antibiotics to friends, family or pets and do not keep leftover antibiotics.
Is there anything I need to do if I’ve been prescribed an antibiotic?
You need to talk to your doctor or pharmacist about any other medicines you might be taking, or any other health conditions you have. Ask yourself the following questions:
• Are you taking other medication?
It is important to tell your doctor or pharmacist if you are taking any other medicines or herbal remedies before you start antibiotics. Antibiotics can interfere with other medicines – for example, blood thinners such as warfarin, also medicines used to treat high cholesterol such as ‘statins’ Also some medicines can interfere with come antibiotics for example calcium supplements.
• Could you be pregnant or are you breastfeeding?
Some antibiotics are unsuitable if you are pregnant or breastfeeding.
• Do you have liver or kidney problems?
Some antibiotics do not work, or you may need a different dose if you have kidney or liver problems.
• Have you any allergies?
Some antibiotics are not used if you could be allergic to them.
• Have you had a gut infection called C diff (Clostridium difficile) in the past?
Antibiotics can make the C diff infection come back again. If you have questions or doubts, always ask your doctor or pharmacist.
Do antibiotics have harmful side effects?
The most common side effects of antibiotics are diarrhoea, stomach pain, a sick tummy and vomiting. Some antibiotics may make your skin more sensitive to the sun. If the antibiotic makes you feel unwell, talk to your doctor, pharmacist or nurse. Some people who take antibiotics can get thrush (candida) of the mouth or vagina. Thrush is a fungal infection, sometimes called a yeast infection. This happens because antibiotics can kill your body’s ‘good’ bacteria. Good bacteria help to stop the fungus growing. Speak with your doctor, pharmacist or nurse if your mouth or vagina gets sore or gets a white coating when you are on antibiotics.
Antibiotics could cause overgrowth of a bacteria known as C diff (Clostridium difficile) in your bowel. This can cause severe watery diarrhoea with stomach pain and cramping. This can happen while you are taking antibiotics and even up to some months after you finish the antibiotics. If you develop diarrhoea that is severe or that lasts for more than a day or two when you are taking antibiotics, contact your doctor
If you are allergic to antibiotics, for example penicillin, you may get a rash and itching or, in severe cases, you might have difficulty breathing. If you have sudden difficulty with you breathing after taking an antibiotic, you should talk to a doctor or nurse immediately. If you are not in hospital when this happens, you should ring for an ambulance immediately.
What is antibiotic resistance and can I help to prevent it?
Antibiotic resistance is when bacteria change in some way and are not killed off by the antibiotic. Bacteria can change very quickly, and if they become antibiotic resistant, an antibiotic that used to kill them no longer works. These bacteria are often called ‘superbugs’. Examples of superbugs include MRSA and CPE.
To help prevent antibiotic resistance, only take antibiotics when you need them. If you take antibiotics when you don’t need them, they may not work so well when you do need them. Many bacteria are already much harder to kill with antibiotics than they were a few years ago. If the bacteria keep ‘overpowering’ the antibiotics we have, we may run out of ways to kill these bacteria. Antibiotic resistance is bad for anyone who has taken an antibiotic, but it is also bad for anyone else who might catch the resistant bacteria afterwards.
Only take antibiotics if they have been prescribed by your doctor, and make sure you take them exactly as you’ve been told to.
This information is approved for use by the HSE’s Antimicrobial Resistance and Infection Control national programme. Text awarded Plain English mark from the National Adult Literacy Agency
Published: January 2019
Healthy Eating With Coeliac Disease
Coeliac disease is a common autoimmune disorder, possibly affecting 1 in 100 people. It is caused by an intolerance to gluten. Gluten is a protein found in WHEAT, BARLEY, RYE & *OATS Gluten is found in foods made with or containing these cereals. Eating foods that contain gluten damages the lining of the small intestine.
What is Hand Foot and Mouth Disease?
Hand, foot and mouth disease is generally a mild illness caused by the coxsackie virus. It is not a serious illness and has nothing to do with the animal disease called foot and mouth disease. It mainly occurs in children from 6 months to 4 years but can also occur in older children and adults.
What are the symptoms?
• Coxsackie virus infection may cause no symptoms at all or only very mild symptoms.
• When symptoms do occur, they include blisters that start as small red dots which later become ulcers. Blisters appear inside the cheeks, gums, and on the sides of the tongue, as well as on the hands and feet. In infants, sometimes blisters can be seen in the nappy area. Blisters usually last for seven to 10 days.
• Children can sometimes have a low fever, sore throat, tiredness, feel off colour and may be off their food for a day or two.
How is it spread?
• Hand, foot and mouth disease is usually spread by person-to-person contact. The virus is spread from the faeces of an infected person to the mouth of the next person by contaminated hands. It is also spread by secretions from the mouth or respiratory system, and by direct contact with the fluid from blisters.
• It usually takes between three and five days after contact with an infected person before blisters appear.
The virus can remain in faeces for several weeks.
Who is at risk?
The viruses that cause hand, foot and mouth disease are common and adults including pregnant women are often exposed to them without symptoms. There is no clear evidence of risk to unborn babies from hand, foot and mouth disease. However, infected mothers can pass the infection onto newborn babies who rarely can have severe disease.
Outbreaks may occur in child care settings.
How can the spread of infection be prevented?
Wash hands often especially after caring for your child.
Avoid sharing cups, eating utensils, items of personal hygiene (for example: towels, washers and toothbrushes), and clothing (especially shoes and socks).
Ensure the mouth and nose are covered when coughing and sneezing. Wipe the nose and mouth with tissues, dispose of used tissues and then wash your hands.
Children with hand, foot and mouth disease should be excluded from school or childcare facilities until their blisters have dried. Hand, foot and mouth disease is not notifiable. However, to help prevent spread, parents should report the illness to the director of the childcare centre or school principal.
How is it treated?
Usually no treatment is needed. As it is a virus, antibiotics are not helpful. Paracetamol or Neurofen will relieve fever and discomfort. Do not give children aspirin. If the headache is severe, or if fever persists, consult a doctor.
The fever & discomfort are usually gone in 3-4 days. The mouth ulcers are usually gone in 7 days. The rash on the hands and feet can last up to 10 days.
Avoid giving citrus, salty or spicy foods and foods that need much chewing. Change to soft diet for a few days and give plenty of small frequent sips of clear fluids. For babies use a spoon, dropper or cup if your baby does not want to suck from a bottle
When should I call the doctor?
Call immediately if your child has not urinated for more than 8 hours your child cannot swallow or the neck becomes stiff, your child becomes confused or delirious or your child becomes hard to awaken completely
Call during regular hours if your child is not drinking much the fever lasts more than 4 days the mouth pain becomes severe gums become red swollen or tender you feel your child is getting worse.
STI Clinics in Galway and the Midlands
Galway STI Clinic
Galway STI Clinic, UCHG –
Offer appointments and also a walk-in service. Please see schedule as follows:-
Wednesday & Friday Mornings - ‘Walk-In’* STI clinic - Doors open at 08:50
* Please note that the walk-in clinic operates on a “first come first served basis” with a maximum quota that can be seen at any one clinic. Please contact the Clinic prior to your visit should you need any further information. Tel 091- 525200
LOCATION: The Clinic located in a self-contained building to the left of the main Hospital. As you enter the hospital grounds (from the university side) take the first left. Follow signs for Genitourinary Medicine Clinic, Infectious Diseases and Hepatology. The Clinic is located to the front of the hospital grounds, in front of maternity services and directly across from the shops in Newcastle Road. Please Clinic should you need further directions or assistance.
Midlands STI clinics
For appointments phone
PORTLAOISE: 086 8591273
Outpatient Dept, Midland Regional Hospital, Portlaoise
MULLINGAR: 086 4169830
Office 10, Ash Unit, Level C,
Midland Regional Hospital,
Mullingar
ALL SERVICES FREE OF CHARGE
Treatment of Gout
What Causes Gout?
A high level of uric acid in the blood causes gout. The uric acid crystallises in the joints, most often at the big toe or knee, and causes inflammation and severe pain. Men are more likely to suffer from gout than women.
How Can Gout be Treated?
1. Medication
Medication will relieve pain and swelling and help prevent future attacks.
2. Diet and Lifestyle
Lifestyle changes such as changing your diet and watching your weight also have a role to play in managing gout.
Tips for Changing Your Diet to Help Treat Gout
Alcohol
Alcohol increases uric acid levels in the blood and therefore moderate consumption is advised. The recommendation for alcohol is as follows:
Men: 21 units per week Women: 14 units per week
1 unit = glass of beer
1 unit = small glass of wine (200ml)
1 1⁄2 units = pub measure of spirit
*Remember to have 2-3 alcohol free days in the week.
Weight
If you are overweight it is advisable to lose weight. This should be achieved gradually as rapid weight loss can result in increased uric acid production by the body. Fast o strict dieting may therefore worsen the symptoms of gout. Aim to lose 1-2lb per week on your weight loss programme including exercise as part of this programme. Do not follow a high-protein low-carbohydrate diet as this can worsen symptoms of gout.
Your dietician will advise you on how to lose weight and set you a suitable target weight.
Fluids
Aim to drink 3-3.5 litres of fluid per day. Adequate fluid intake helps dilute urinary uric acid.
Purine Rich Foods
Special attention needs to be paid to foods that are high in purines as regular or excessive consumption these foods increase the level of uric acid in the bloodstream. Some restriction is advisable your Dietitian will advise you on this.
Main Dietary Sources of Purines.
Meat sources:
Liver Heart Kidney
Sweetbreads Meat extracts (e.g. oxo)
Fish sources: Anchovies Mackerel Crab
Sardines Fish roes Shrimps
Herring Sprats Whitebait
Other sources:
Yeast and extracts
Beer
Asparagus Cauliflower Spinach
Mushrooms Beans and peas