kry.co.uk > Your health

Health information, articles, news and advice for NHS patients.

kry.co.uk > Your health > Metainfo

Your health | KRY

We’ve all felt that horrible feeling when a joint feels like it’s jolted or jarred out of place. Whether you’ve hurt yourself running, playing sport or falling over, it can be hard to know if the pain is caused by a sprain, a strain or even a fracture.

Knowing what to do if you or someone else is injured can help to ease the pain and start the healing process. The best way to treat minor sprains is to follow the RICE method – Rest, Ice, Compression and Elevate.

## What is a sprain and what causes it?

A sprain is a common injury that happens when you stretch or tear a ligament (the strong elastic band of tissue that connects the end of one bone to another in a joint). 

It happens usually as a result of sudden movement to the affected joint out of its normal range of movement. This leads to a stretch or tear of the ligament. Ankle, wrist, knee and thumb sprains are the most common.

## What’s the difference between a sprain and a strain?

Though their symptoms are quite similar, the main difference between a sprain and strain is that a strain tends to affect the muscle, while a sprain affects the ligaments. 

A strain happens when you stretch or tear a muscle or tendon (the strong tissue that attaches muscle to bone). It’s usually caused by stretching the affected muscle beyond its normal range of movement. Foot, hamstring and back strains are the most common. 

| __Sprain__ | __Strain__ |
| ---------- | ---------- |
| Stretch or tear of a ligament | Stretch or tear of a muscle or tendon |
| Commonly affects the ankles, wrists, knees and thumbs | Commonly affects the feet, hamstring and back |

## What are the symptoms of a sprain?

If you have a sprain, you’ll likely experience these symptoms in the affected area:
- Pain or tenderness around the joint
- Swelling
- Bruising
- Reduced function or movement of the joint
- Pain when you put weight on the joint
- Joint instability (the feeling that the joint is about to give way) or weakness

## What are the most common types of sprain?

### Sprained ankle

A sprained ankle can be caused by landing awkwardly on your feet after jumping or twisting your ankle as a result of a fall or during exercise. It can also happen when you experience direct trauma to your ankle – for example, someone stepping on your ankle when playing a team sport.

Key symptoms of a sprained ankle:
- Swelling of your ankle
- Pain and tenderness in your ankle
- Difficulty putting weight on your feet or walking

### Sprained wrist

A sprained wrist is caused by an impact to the wrist that forces it to move out of its normal range of movement. This can happen when you put your arms out to brace for a fall, during a car accident or when playing a sport. 

Key symptoms of a sprained wrist:
- Swelling of your wrist
- Pain and tenderness in your wrist 
- Numbness or tingling in your wrist
- An inability to move or use your wrist normally

### Sprained knee

A sprained knee can be caused by any movement that stretches the ligaments in the knee. This can include a sudden twisting of the knee joint, falling on your knees or a sudden collision or trauma to your knee in an accident or while playing a sport. 

Key symptoms of a sprained knee:
- Swelling of your knee
- Pain and tenderness in your knee
- Bruising of your knee joint
- Stiffness or instability of the knee
- Difficulty putting weight on your knee

## How do I treat a sprain?

The first thing to do if you think you have a sprain is to perform RICE therapy. This is a simple 4-step process that helps to reduce any swelling:

1. __Rest__ – stop any activity or exercise that uses the joint and avoid putting any weight on it
2. __Ice__ – place an ice pack (or a bag of frozen peas wrapped in a towel) on the affected joint for about 20 minutes every 2-3 hours
3. __Compression__ – wrap the joint with a bandage or compression sleeve to provide more support
4. __Elevate__ – keep the joint raised as often as possible – for example, using a pillow in bed

In the first few days of RICE therapy, try to avoid heat from heat packs or hot showers and baths. This will prevent any more swelling. 

When you’re able to move the joint without a lot of pain, do your best to keep moving it to prevent it from stiffening.

As well as following the RICE method, you can also take some over-the-counter painkillers to help relieve pain and tenderness in the joint. Paracetamol is a good first option to try to manage the pain. You could also use ibuprofen gel, cream or spray on the joint to manage the pain and swelling

## Are there any red flags to look out for with a sprain?

There are some symptoms to look out for that might suggest you need to seek medical help. If you experience any of these symptoms, call 111 to seek further help:

- A red, hot and swollen joint
- It’s tender when you touch either the maeloli (the bony bumps either side of your ankle) or around the foot area
- A very unstable joint
- Numbness in the area
- Misalignment or asymmetry in the joint
- You can not walk 4 steps at the time of the injury and following
- You heard a ‘crack’ or ‘pop’ when the injury occurred
- You think you’ve broken a bone

## How long will it take for a sprain to heal?

This can vary depending on the severity of the sprain. Most sprains tend to improve after 2 weeks and get back to normal after 12 weeks, but a more severe sprain can take a few months to heal completely.

## How can I prevent a sprain?

There are some simple things you can do to prevent a sprain in the future:

- Always warm up before and cool down after intense exercise
- Use protective braces or sleeves to support the joints
- Maintain a healthy weight and keep your muscles strong
- Use appropriate equipment and wear supportive shoes when exercising or playing sport

## When should I speak to a doctor?

You should speak to a doctor if your symptoms haven’t improved after a few weeks or if you experience any of the red flag symptoms included above.

__This article has been medically reviewed by Dr Bryony Henderson, Lead GP at Kry.__


Article > What is a sprain – and what helps?

What is a sprain

A sprain is a common injury that happens when a ligament is damaged. Discover the best way to manage a sprain.

What is a sprain – and what helps?

What is a sprain – and what helps? | Kry

kry.co.uk > Medical Reviewer

Dr Bryony Henderson

Lead GP at Kry

The immune system is one of our body’s hardest-working systems. All organisms – from bacteria to sea sponges to apes – have some form of immune system to defend them from harm.

We still don’t know exactly how our immune system works, but we know its aim: to protect us from anything that could hurt us. 

It’s a simple goal, but our immune system uses some sophisticated strategies to keep us safe. Here’s what you need to know.

## What is the immune system?

The immune system is made up of cells, tissues and organs that work together to protect you from infections and other harmful substances. Its goal is to identify and kill anything in your body that shouldn’t be there. 

When everything goes to plan, your immune system defends you from all kinds of attacks without you noticing. But if things stop running smoothly or you encounter a particularly clever or aggressive invader, you get sick.

## What are the different parts of the immune system?

The immune system has 2 branches: the innate immune system and the adaptive immune system. 

### 1. The innate immune system
We’re born with the ability to defend ourselves from invaders. Our [innate immune system](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4863567/) arms us with non-specific protection against any kind of germ or harmful substance. This first line of defence includes:

- Physical barriers like skin and mucous membranes
- Chemical barriers like bacteria-killing enzymes in our snot, tears and stomach acid
- Immune cells - such as phagocytes
- Antibodies

If a germ manages to get past our innate immunity, our adaptive immune system steps up. 

### 2. The adaptive immune system
Your adaptive immune system takes a more specialised approach. It learns and ‘remembers’ the specific germs you’ve been infected by, allowing you to launch a quicker counterattack the next time they intrude. Scientists call this ‘immunological memory’.

The main defenders in your adaptive immune system are lymphocytes, a white blood cell, (called B cells and T cells) and antibodies. 

__B cells__

B cells are made in the bone marrow. They specialise in making antibodies. There are many different types of B cells that make antibodies against particular threats. 

__T cells__

T cells are also formed in the bone marrow but mature in the thymus, a small organ in your chest. There are a few different kinds:

- Helper T cells signal to other immune cells to join the fight against an infection 
- Killer, or cytotoxic, T cells detect and kill infected cells or cancerous cells
- Memory T cells remember pathogens you’ve previously been infected by

__Antibodies__

Antibodies, also known as immunoglobulins,  are Y-shaped proteins that circulate in your bloodstream, patrolling for intruders. When they find something harmful, they’ll latch on. This ‘neutralises’ the infection, making it harder for the germ to hurt you. It also signals to your immune cells that there’s an intruder to fight off.

Anything that triggers your body to make antibodies is called an antigen, short for antibody generator. An antibody will only attach to an antigen if it matches it perfectly, like a lock and key. This is how your immune system recognises particular intruders. Your body makes specialised antibodies that match specific germs and other threats. 

There are 5 different types of immunoglobulins - IgG, IgM, IgA, IgD and IgE - and each has a specific job to do. For instance, IgG and IgM go into organs on the hunt for intruders whilst IgA is found in mucus. 

If your body encounters something for the first time, it can take time for your immune system to create an antibody that fits the antigen and, until it does so, you can become ill. 

## How does vaccination work?

Your immune system’s memory is the reason why [vaccines work](/your-health/why-are-vaccines-and-immunisations-so-important/). Vaccines contain a dead or weakened version of a pathogen, which stimulates your immune system to make antibodies that match it. This gives your adaptive immune system the upper hand the next time you’re exposed to the same pathogen, since it’s already made the antibodies. 

## What is inflammation​?

Inflammation happens as your immune system mounts a counterattack against a threat. Your blood vessels dilate to bring more blood to an area of injury or infection, carrying white blood cells ready for battle. This extra blood flow leads to redness and swelling. Your white blood cells release chemicals called cytokines that attack any invaders. 

While inflammation helps you fight off an infection, it’s also what makes you feel sore, feverish and ill. Some degree of inflammation is necessary, but too much can be dangerous. 

A [cytokine storm](/your-health/what-is-cytokine-storm/) is when your innate immune system launches too many defences at once, which is why we sometimes use medicine to keep inflammation under control. 

## What happens when the immune system goes wrong?

Our immune system is constantly on patrol, checking out anything new that enters our bodies and deciding whether or not to let it pass by in peace. 

Allergies and autoimmune diseases are all a result of our immune system mistaking harmless or even beneficial things for a threat. 

### Autoimmune diseases
Your immune system has to be able to recognise what’s part of you and what’s not. Autoimmune diseases happen when your immune system mistakes itself for an invader and attacks. It’s estimated around 5% of people have an autoimmune disease. These include:
- [Multiple sclerosis](https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiVxrr8wo35AhUQa8AKHRxDBd8QFnoECAIQAQ&url=https%3A%2F%2Fwww.livi.co.uk%2Fmedical-advice%2Fneurological-disorders%2Fmultiple-sclerosis%2F&usg=AOvVaw2OPSEaXtLjopp1DovsfIb0)
- Type 1 diabetes
- [Lupus](https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwiJ2vCGw435AhWFolwKHVJvCeoQFnoECAMQAQ&url=https%3A%2F%2Fwww.livi.co.uk%2Fmedical-advice%2Fautoimmune-diseases%2Flupus%2F&usg=AOvVaw0yagIKEOo9y5MoioQAG7gj)
- Rheumatoid arthritis
- [Crohn’s disease](https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjc4dKhw435AhVCQEEAHWuOB74QFnoECAQQAQ&url=https%3A%2F%2Fwww.livi.co.uk%2Fmedical-advice%2Fdigestive-problems%2Fcrohns-disease%2F&usg=AOvVaw2g185FgjpmzXyvpUxPU-Yp)

### Allergies
An allergy is an overreaction of the immune system to a harmless substance. It’s predicted that by 2025, over half the European population will have at least one allergy. 

Some of the most common types of allergens are:
- Antibiotics
- Pollen
- Food
- Latex
- Insect stings

## When should I speak to a doctor?

While there’s a wide range of immune disorders with a variety of effects, here are some signs that you may need to speak to a doctor:
- Joint pain and swelling
- Abdominal pain or digestive issues
- Recurring fever
- Swollen glands

__This article has been medically reviewed by Dr Bryony Henderson, Lead GP at Kry.__

Article page > How does the immune system work?

Immune system

Our immune system protects us from everyday threats, from bacteria to viruses to cancer. How does it work?

How does the immune system work?

How does the immune system work? | Kry

Concussion is a short-term injury to the brain that tends to last for a few days or weeks. If you’ve had a bad bump to the head – or you’re with someone who’s had an accident – and are not feeling well, look out for [concussion](https://www.livi.co.uk/medical-advice/neurological-disorders/concussion/) symptoms. 

The majority of head injuries aren’t serious but knowing the red flag symptoms will help you know when to seek medical help for yourself or someone else.

## What are the key symptoms of concussion?
Here are the typical signs of a concussion, that can also be delayed concussion symptoms.
Mild concussion symptoms you may experience yourself:
- Headache or pressure inside your head
- Nausea or vomiting
- Dizziness or balance problems
- Double or blurred vision
- Light or noise sensitivity
- Feeling sluggish, confused or having problems concentrating

Signs of concussion in someone else:
- Appear stunned or dazed
- Can’t recall events immediately prior to or after the injury
- Move clumsily
- Exhibits personality or mood changes
- Answers questions slowly

‘Symptoms of a concussion usually show after a few minutes or hours of getting a head injury,’ explains Dr Rhianna McCylmont.

‘I often get asked about how long concussion symptoms should last, but they can vary hugely from person to person. Some people may not get any post-concussive symptoms for a few days or even weeks – and so it’s important to keep an eye out for anything unusual soon after the head injury.’

## When to call 999 and when to go to A&E?
If symptoms worsen a few hours after the initial head injury, there’s a risk that there’s a more serious brain injury so seek emergency medical assistance.

__Call 999 if they:__
- Haven’t regained consciousness
- Fell from a height that’s over 1m (or 5 stairs)
- Have a wound with something embedded
- Have neck or back pain
- Have numbness or weakness in a part of their body
- Are having problems with vision
- Are bleeding or vomiting profusely (especially bleeding from the ears)
- Are having a seizure
- Are struggling to keep their eyes open or staying awake
- Are having problems with understanding, talking, walking or balance
- Have a transparent liquid coming out of their ears or nose
- Have some bleeding or bruising around their ears
- Have a black eye with no obvious damage around the eyes

__Go to A&E if they__:
- Have lost consciousness then woken up
- Vomited after the injury
- Have a headache that’s resistant to painkillers
- Are having problems with memory
- Are experiencing changes in behaviour, like getting irritable
- Have a blood clotting disorder or take blood thinners
- Have had brain surgery
- Have been drinking alcohol or taking recreational drugs
- Are a child under 12 months of age

## How long does a concussion last?
Generally, the more severe the injury, the longer it takes to recover from a concussion. Most people recover within 2 weeks to 1 month. Some people take longer than average to recover, including older adults, those with prior concussion injuries and those with pre-existing neurological conditions

## What are delayed concussion symptoms?
Delayed concussion symptoms include headaches, dizziness, insomnia, irritability, anxiety, ringing in the ears or loss of concentration. If you’re not fully recovered after several weeks, you should see a doctor again to check for post-concussion syndrome.

## What is post-concussion syndrome?
Occasionally, concussion symptoms can cause some long-term problems. These side effects are known as post-concussion syndrome and include headaches, dizziness, memory problems, unsteadiness, depression, anxiety and unusual behaviour.

It’s best to speak to a GP if you still have post concussion symptoms after 3 months. They may be able to recommend treatment or can refer you to see a specialist.

## What are the stages of concussion recovery?
Everyone’s [recovery from a concussion](https://www.livi.co.uk/medical-advice/neurological-disorders/concussion/) will be slightly different, but there are several general stages most people experience.

__1. Acute phase__ – this happens immediately after the concussion, doctors recommend injury rest for 24–72 hours. This means getting sufficient sleep and reducing all activity. Anyone who has suffered a head injury shouldn’t be left on their own for at least 48 hours after the incident

__2. Gradual return to everyday life__ – engaging in vigorous exercise too quickly increases the risk of another brain injury. Try minimising screen time as much as possible and avoid driving anywhere.

You may experience symptoms during your recovery that don’t require medical help. These symptoms should resolve over time and include:
- Headaches
- Dizziness
- Nausea
- Disturbed sleep
- Irritability
- Fatigue
- Feeling anxious and tearful
- Sensitivity to light and/or sound

## Concussion in a child or baby
‘If a child or baby has had a minor head injury, I would always recommend speaking to a GP – or if the fall or knock was severe, take them to your nearest A&E to be checked for a concussion,’ says Dr McClymont.

‘Watch out for any strange behaviours, excessive tiredness, being sick or problems with their balance, appetite or movement,’ she says.

‘As it can be much harder to spot concussion symptoms in a child or baby than an adult, it’s best to get advice from a doctor straight away, rather than treat them at home.

Livi GPs may advise you to see a doctor face-to-face, rather than having a video appointment.

## Advice for preventing head injuries
Having repeated knocks to the head or multiple concussions can then lead to more serious problems.

‘Although getting a head injury or severe concussion isn’t always avoidable, there are a few lifestyle choices and measures you can take to reduce your risk of a serious head injury,’ suggests Dr McClymont.

- Wear the right protective clothing for contact sport like rugby or boxing
- Make sure there are people qualified in first aid to supervise contact sports
- Always wear a seat belt when driving or as a passenger
- Wear a helmet on a bicycle or motorcycle
- Keep your home and garden clear of slipping hazards, especially the stairs

## When should I speak to a doctor?
Speak to a doctor if you’re concerned about concussion symptoms or a head injury. Especially if:

- Your concussion symptoms have lasted more than 2 weeks
- You’re unsure whether it’s safe to return to work, school or sports
- You’re concerned about possible long-term side effects

Contact emergency services if you need urgent care.

__This article has been medically approved by Livi Lead GP Dr Rhianna McClymont__

kry.co.uk > Speak to a GP about concussion symptoms > CTA

Speak to a GP about concussion symptoms

Livi.co.uk > Your health >  What to do if someone is showing concussion symptoms

Concussion

Dr Rhianna McClymont shares the expert medical advice on spotting the signs of concussion and when emergency treatment is needed

Kry.co.uk > Your health > What to do if someone is showing concussion symptoms

What to do if someone is showing concussion symptoms | Kry UK

kry.co.uk > medical reviewer

IMG 20200730 224911 865-33- 1 .jpg

Dr Rhianna McClymont

General health

General health and seasonal

What to do if someone is showing concussion symptoms

It’s not easy to know someone you care about isn’t feeling like their usual self. Being close to someone who’s depressed can have an impact on your relationship, especially if you’re living with someone who has depression. It’s normal to feel confused, overwhelmed or unsure about what you can do to help. 

‘Although it can be difficult to know what to say to someone who is depressed, supporting them can play a really important role in helping them feel better and keeping your relationship strong,’ says Dr Oyefeso.

## What can cause someone to feel depressed?
[Depression](/medical-advice/mental-health/depression/) can affect anyone and the causes vary between different people. Some people become depressed without any clear reason, and for some it might be down to certain factors or life events. 

- A person might experience depression because:
- They had a difficult childhood, for example neglect or an unstable family situation
- They’ve [lost someone close to them](/your-health/a-therapists-advice-for-coping-with-grief-in-your-own-way/)
- Their relationship has ended
- They’ve lost a job or are going through a period of unemployment
- They experience bullying or abuse including racism and homophobia
- They use recreational drugs, alcohol or medication that affects their mood
- They have other mental health struggles like [anxiety](/medical-advice/mental-health/anxiety/) or [low self-esteem](/your-health/how-can-i-build-my-self-esteem/)
- They have a physical health problem like chronic pain, a disability or hormonal issues

Understanding what could have caused someone’s depression can be key to giving them the support they need. 

## What are the signs a friend or loved one is depressed?
‘Until your friend opens up, you may not know exactly how they feel. But there are certain behaviours you can look out for to help know if they have depression,’ says Dr Oyefeso. 

Signs to look out for include:
- Avoiding activities and social events
- Getting less pleasure out of things they’d usually enjoy
- A [reduced sex drive](/your-health/8-causes-of-low-libido-a-doctors-guide/)
- A lack of confidence
- Constant tiredness
- Difficulty concentrating or keeping up with conversation
- [Difficulty sleeping](/your-health/how-to-sleep-better/) or sleeping too much
- Sudden weight gain or weight loss from a [reduced appetite](/your-health/8-causes-that-could-explain-your-loss-of-appetite/)
- Smoking and drinking more, or taking recreational drugs
- Displaying signs of self-harm, like marks on their arms

## 9 tips to help someone with depression
### 1. Show and remind them you care
‘The first important step you can take is to let your friend or loved one know you’re there, and want to help as much as you can,’ says Dr Oyesefo. ‘Just being present and available to talk can make a big difference. Some people want face-to-face interaction, while others prefer a phone conversation.’

### 2. Meet for regular walks
‘Getting enough exercise and fresh air is an integral part of managing depression and can help improve mood, increase energy levels, and promote better sleep,’ Dr Oyefoso explains.

If someone you know is dealing with depression, encourage them to get regular exercise by joining them – this could be an opportunity for them to talk about how they’re feeling too.

### 3. Take it in turns to cook meals
What we eat can have a significant impact on our mood. While we know eating healthily is vital for our physical health, [research proves](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769512/) that it can also help manage depression. You could try cooking healthy meals together or take it in turns to cook for each other to help them maintain a balanced diet.

### 4. Try something new together
‘Something that can really help people recover from depression is finding meaning and purpose in life,’ says Dr Oyesefo. ‘You can start them on this journey by helping them find a hobby or activity that brings them joy, or helping them volunteer for a cause they feel passionate about.’

### 5. Help keep them stress-free
When someone is feeling depressed and lacking energy, it can be hard for them to keep on top of their everyday tasks. Help them stay in control by picking up some shopping for them, offering to do one of their household chores or asking them what they’d appreciate from you to take some weight off their shoulders.

### 6. Talk about getting professional help
‘Depression is a real condition that often needs treatment from a qualified mental health professional. This can involve [talking therapy](/your-health/is-talking-therapy-for-me/), medication or a combination of both,’ says Dr Oyefeso.

If a person with depression doesn’t want to get in touch with a professional, reassure them that it’s okay to ask for help when they feel ready.

### 7. Help them build a network
‘One of the best things you can do for someone with depression is to help them develop a support system,’ advises Dr Oyesefo. ‘This might involve connecting them with friends or family members who can offer emotional support, or helping them find a support group of other people with depression.’

### 8. Find specific support groups
‘There are also support groups available for substance abuse, which is a common problem among people with depression. [Alcohol and drugs](/medical-advice/mental-health/support-for-addiction) can make depression worse and can also lead to other issues. If this is the case for someone you know, find a local support group they can join.’

### 9. Look after yourself too
Taking care of someone close to you might put a strain on your own wellbeing, but remember that your mental health is important too. Make time for your own enjoyment and relaxation, and don’t be afraid to ask your own friends or relatives for help. Take a look at our [mental health hub](/medical-advice/mental-health/) if you need more support.

## What to say to someone with depression

Positive reinforcement is often key to helping someone manage their depression. Here are some examples of ways you can offer reassurance.

1. __“Everything is going to be okay”__
This helps them take small steps to improve their situation.

2. __“Your feelings are valid”__
You can acknowledge that depression is a real but treatable illness.

3. __“It’s not your fault”__
Depression is not self-inflicted or something that can be quickly fixed.

4. __“You’re a good person”__
Minimise their guilt about being too unwell to work or socialise.

5. __“You’re not a burden”__
It’s important they feel comfortable about opening up or asking for help.

## What further help is available for someone with depression?
‘[Talking therapy](/your-health/is-talking-therapy-for-me/) has been proven to help with mild to moderate feelings of depression – a therapist can help someone understand their emotions and navigate through difficult life events,’ explains Dr Oyefeso.

Antidepressant medication is sometimes recommended. A GP can prescribe medication if it’s necessary, and introduce your friend or relative to the right mental health service for them. 

If you think someone is in danger or they're [expressing suicidal thoughts](/your-health/what-to-do-if-youre-having-suicidal-thoughts-a-psychologiss-advice/), call 999 or go to A&E straight away.

Call 111 if it’s not an emergency but someone might need urgent medical help for their mental health.

__This article has been medically approved by Dr Adenekan Oyefeso, Psychologist at Kry.__

Kry.co.uk > How to help someone with depression > CTA 

Speak to a GP

kry.co.uk > Your Health > How to help someone with depression

How to help someone with depression

Supporting a friend or loved one with depression can play an important role in helping them feel better. A Kry psychologist shares their advice. 

How to help someone with depression | Kry

Medical review

Dr Adenekan Oyefeso

Psychologist and Clinical Lead for Mental Health at Kry

Supporting others

Though many of us find the thought of taking a poo sample daunting, [your poo can tell you a lot about your health](/your-health/10-things-your-poo-can-tell-you-about-your-health/). It’s always worth getting it checked out if you suspect something isn’t right. 

A stool sample can help to detect anything from a bad stomach bug to an E. coli infection. It’s also one of the best ways to detect signs of [bowel cancer](/medical-advice/digestive-problems/Bowel-cancer/). 

## What is a stool sample test?

A stool sample test involves depositing some of your poo, usually into a pot. A doctor can then use this sample to investigate further, depending on your symptoms. 

There are different types of stool sample tests that your doctor can suggest, depending on the problem being investigated. 

A nutritional therapist or medical practitioner may also recommend you do a stool sample test to check your gut health.

## What are the main different types of stool sample test?

### A test for blood in your poo
One of the most common stool sample tests looks for blood in the stool. It’s important to remember that blood in your stool isn’t always easy to see. This is sometimes known as a faecal occult blood test – ‘faecal’ is the Latin name for poo, and ‘occult blood’ means blood that isn’t visible to the eye.

### A test for bacterial cultures in your poo 
This checks for the presence of bacteria such as salmonella, shigella or E. coli in the gut. In the UK, you might have this test if you’re experiencing diarrhoea after a stay abroad, for example. 

### Screening for bowel cancer
Bowel cancer is the [fourth most common type of cancer in the UK](https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bowel-cancer#heading-Zero), and screening can help to detect it at an early stage. 

Currently, [NHS bowel screening checks](https://www.nhs.uk/conditions/bowel-cancer-screening/) are available to everyone aged 60-74 years. The programme is growing to include everyone from 50-59 years across the next 4 or so years. 

For this, you use a home test kit called a faecal immunochemical test (FIT) to collect a small sample of your poo. This will then be sent to a lab to check for tiny amounts of blood.

## How do I know if I need a stool sample test?

Healthcare professionals will assess if and when you need to provide a stool sample. But some key symptoms might include:

- Diarrhoea or stomach sickness that doesn’t go away on its own
- Blood in your stool or anything that looks dark and tar-like in your poo
- A change in your bowel habits
- Lower stomach pain

## What can be picked up in a stool sample?

Stool tests can help to investigate:

- An infection caused by bacteria such as salmonella, shigella or E. coli
- A parasite 
- [Worms](/medical-advice/digestive-problems/threadworms/)
- Inflammatory bowel disease (IBD)
- Fat malabsorption – if you have abnormally high amounts of fat, this could be a sign that you’re not digesting it properly and may need further tests
- Bowel and colon cancer

## What happens if I have blood in my stool?

Blood in the stool can have many possible causes. The most common causes are:
- [Haemorrhoids](/medical-advice/digestive-problems/piles/) (or piles)
- A rupture or tear of the rectum
- Ulcers

Other causes can include:
- Stomach upset – the lining of the intestine can become weak after an intense stomach upset, which can lead to blood in your poo
- Some medicines – blood thinners and anti-inflammatory drugs can cause bleeding in your gastrointestinal tract

Blood in your poo can also be caused by more serious diseases, such as:
- Crohn’s disease
- Ulcerative colitis 
- Some forms of bowel cancer 

Foods such as beetroot and blueberries can darken your poo and be mistaken for blood. Speak to a doctor if you’re unsure.

## How does a stool sample work?

Most stool tests are done at home. It’s important to follow the instructions provided as the method of sampling may differ. A doctor or other healthcare professional, like a nurse, will explain how to collect the sample. 

Usually, you’ll collect the poo in a clean, dry screw-top container using a spatula. The test is usually quick, easy to do and completely pain-free. Here’s a [simple step-by-step](https://www.nhs.uk/common-health-questions/infections/how-should-i-collect-and-store-a-stool-faeces-sample/) of how to do a stool sample:

1. Fill in your details on the label on the container.
2. Place something in the toilet like a potty to catch the poo, or try spreading plastic wrap or lots of toilet paper over the rim of the toilet. 
3. Make sure the poo doesn’t touch the inside of the toilet.
4. Use the spatula that comes with the container to collect your poo and transfer it to the container, then screw the lid shut.
5. Try to fill around one-third of the container.
6. Put anything you used to collect the poo in a plastic bag, tie it up and put it in the bin.
7. Wash your hands with soap and warm water.
8. Follow any other instructions the doctor has given you – usually this will mean handing your stool sample in as soon as possible, as it’s important for your poo to be fresh when it’s tested.

Sometimes, you need to take the test on different occasions or a few days apart, to make the examination more reliable. 

If you have periods or bleeding haemorrhoids, you should consult your doctor about when to have the test. 

## When should I speak to a doctor?

If you’re having bowel problems or worried about blood in your poo, speak to a doctor. Always seek medical attention if you have:

- Visible blood in your poo or dark stools
- Changed bowel habits (without a significant change in your diet)
- Pain in your stomach that doesn’t go away
- Fatigue that can’t be explained
- Unexplained weight loss

If you’re experiencing heavy bleeding with diarrhoea, contact emergency services as soon as possible.

__This article has been medically reviewed by Dr Bryony Henderson, Lead GP at Kry.__


kry.co.uk > Your health > Stool sample

Stool sample

Do you have diarrhoea or constipation, or have you noticed blood in your poo? A stool sample test may be a good idea. Here’s how it works and what it tests for

How does a stool sample work? | Kry UK

Gastroenterologists

How does a stool sample work?

Whether you’ve just started talking therapy or are only considering it, taking action to look after [your mental health](/your-health/talking-about-mental-health-with-a-gp/ "Talking about your mental health") can feel like a big step. It’s a good idea to start thinking about what you’d like to get out of therapy and how to get the most value out of the experience. 

## What is therapy?
Therapy is a form of psychological treatment that involves talking about your thoughts, behaviour and emotions with a trained therapist. It can be a really useful way to help you deal with or overcome mental health problems such as [depression](/medical-advice/mental-health/depression/), [anxiety](/medical-advice/mental-health/anxiety/) or [stress](/medical-advice/mental-health/stress/). 

There are a number of different types of therapies, but some are more suitable for certain types of problems. People will also be more suited to certain types of therapy, so there’s no one-size-fits-all approach. 

The person delivering the therapy will depend on the type and intensity, but they can be counsellors, therapists, psychologists or psychiatrists.

To help make your experience of therapy as useful as possible, here are 7 things to consider before, during and after therapy. 

## What to consider before you start therapy

### 1. Make sure talking therapy is the right thing for you now 

[Talking therapy](/your-health/is-talking-therapy-for-me/ "Is talking therapy for me?") may be a good idea if you need help coping with a challenging life situation or a mental health problem. But you don’t have to be going through a crisis to try it – it can also help support your personal development. Sometimes, just talking to someone who isn’t a friend or family member can be a helpful healing process.

It’s worth noting that having therapy is a commitment, and it requires work from your side. Consider whether you feel ready to talk and open up about your feelings. Therapy often requires you to talk about the most personal of things and this can be hard to do if your emotions are still very raw. 

It’s important to remember that therapists are trained to help you navigate your experiences, thoughts and feelings at a pace that suits you. They’re there to help in a way that makes you feel psychologically safe and comfortable. 

### 2. Understand the type of therapy you’re getting 

There are several different types of therapy – from CBT therapy to group therapy – and it can be hard to know which is best suited for you. Doctors recommend certain types of therapies for specific issues, so it can be helpful to speak to a GP or a specialist about your options. It can also be useful to read about each type so you can make a judgement on which is most suited to your personality and preferences. 

### 3. Think about what you might want to achieve 

Ultimately, you’re doing this to help yourself, so think about what you want to get out of therapy. You may want help coping with a traumatic experience, [processing grief](/your-health/a-therapists-advice-for-coping-with-grief-in-your-own-way/) or developing techniques to [lower your anxiety](/your-health/need-help-for-anxiety-here-are-your-questions-answered/) levels. It can even be helpful to write your thoughts down so both you and your therapist are clear about what your goals are.

## How to maximise your time during therapy

### 4. Make sure you have a comfortable and private set-up 

Therapy involves talking about personal thoughts and issues. So, if you’re trying digital therapy and having your sessions from home, make sure you have a comfortable, private setting. If you don’t feel comfortable or think people are able to listen in, it can be very hard to properly open up and get the most out of a session. 

Equally, if your session takes place outside the home, make sure that you’re comfortable in that environment.

### 5. Try to be open and honest with your therapist 

This can be one of the hardest parts of therapy, but discussing your thoughts and feelings openly is key. Therapy should be a safe space where no judgement is passed and your therapist will work to help create this atmosphere. 

Don’t worry if you don’t feel like this immediately, as it can sometimes take a while for this trust to develop. It’s also important that you aren’t afraid to tell your therapist if you feel some things aren’t working. This can really help them personalise your therapy. 

### 6. Set realistic expectations 

Try to remember that therapy isn’t a magic bullet that will solve your problems immediately. It can be a long process – usually between 6-8 sessions, while some people may need therapy for a longer period. 

However, if you don’t find it helpful, or after this time you don’t feel that you’re getting out of it what you’d like, you can talk to your therapist about making a change in the type of therapy you receive. You can also speak to a doctor who may be able to help with changing your therapist or exploring other options.

## What to think about after therapy 

### 7. Try to take your learnings with you

Therapy can be a great way for you to see things more clearly, but your session will only take up a small proportion of your week. To really benefit, try to take your learnings from each session with you and implement some of the techniques you learn into your everyday life. It can help to write these down so that you can reflect on them at a later stage. Speak to your therapist about some practical ways to help you do this. 

## When should I speak to a doctor or therapist?

If you’re interested in therapy, it’s a good idea to speak to a doctor. They can help you find the best option for you. 

It might be a good idea to speak to a doctor or therapist if:

- You’re feeling low on a regular basis
- You’re struggling with anxiety or stress
- You’re experiencing [depression](/medical-advice/mental-health/depression/) or another mental health issue
- You need support with [grief](/medical-advice/mental-health/grief/), a difficult life change or a traumatic experience

__This article has been medically reviewed by Dr Bryony Henderson.__


Section > Call out > GP CTA for content

kry.co.uk > Your health > 7 ways to get the most out of therapy

How to get the most out of therapy

Talking therapy can feel daunting, particularly when you don’t know what to expect. Read our guide on the steps you can take to get the most out of it

kry.co.uk > Your health > Meta info > How to get the most out of therapy

7 ways to get the most out of talking therapy | Kry UK

Medical reviewer

Dr Alessio Platania

Everyday mental wellbeing

7 ways to get the most out of therapy 

Kry.co.uk > Womens health hub > Banner

[Menopause](https://www.livi.co.uk/your-health/what-age-will-i-reach-menopause-a-doctors-guide/) is when your periods permanently stop. It usually happens between age 45 and 50, and menopause between the ages of 40 and 45 is called early menopause. If menopause occurs before the age of 40, this is called premature menopause.

Around [5% of women](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4581591/) begin menopause early, while 1% experience premature menopause. There are several possible causes, but it can also happen for no clear reason. While going through menopause is a natural part of life, it can feel like an especially big change if it happens at an earlier age. 

## What are the signs of early menopause?

The main sign of early menopause is your periods becoming less frequent or stopping altogether. You may also experience symptoms like:

- Hot flushes
- Night sweats
- Difficulty sleeping 
- Vaginal dryness, irritation or urinary problems
- [Low libido](https://www.livi.co.uk/your-health/8-causes-of-low-libido-a-doctors-guide/)
- Low mood
- Anxiety
- Difficulty concentrating or remembering things

## What causes early menopause?

Early menopause can be triggered by natural or medical causes, including:

### Primary ovarian insufficiency

Primary ovarian insufficiency (POI) is when the ovaries stop working before age 40. It happens in about [1% to 2% of women](https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-018-0665-2) under 40 and much fewer women under 30 (around 0.1%).

It used to be called primary ovarian failure, but that name was found to be inaccurate. The ovaries don’t always stop working completely, and some people with POI still have periods from time to time, so pregnancy is still possible in some cases. 

Around [90% of the time](https://www.statpearls.com/articlelibrary/viewarticle/136054), the cause of POI isn’t clear. Some potential triggers may include:
- Genetic disorders like Turner syndrome
- An autoimmune disease
- Certain infections

POI is diagnosed by testing your levels of hormones, including follicle stimulating hormone (FSH). This will need to be checked twice so that the diagnosis can be confirmed. 

### Surgery to remove the ovaries

Having surgery to remove your ovaries before your periods stop, such as in addition to the uterus during a hysterectomy, causes early menopause. Removing the ovaries means you’ll lose the hormones they produce, including oestrogen and progesterone. 

### Medical treatments

Cancer treatments like chemotherapy and radiation can trigger early menopause. Sometimes this is temporary, but if you’re close to the natural age of menopause, it may be permanent. A doctor will be able to tell you what may happen in your situation and what options you have. 

## What does early menopause mean for my health?

Menopause causes your levels of oestrogen and other hormones to drop off. This can affect things like your mood and cognition. After menopause, women are also at a higher risk of health issues like [cardiovascular disease](https://www.livi.co.uk/medical-advice/cardiovascular-diseases/) and [osteoporosis](https://www.livi.co.uk/medical-advice/musculoskeletal-disorders/osteoporosis/). 

To help your bones stay healthy, make sure you’re getting enough [vitamin D](https://www.livi.co.uk/your-health/do-i-have-a-vitamin-d-deficiency-symptoms-causes-and-treatments/) and calcium in your diet. 

There are also treatments you can take to relieve your symptoms and lower your risk of other health problems. 

## How is early menopause treated?

The main treatment for early menopause is taking medicine to replace the hormones you’re missing. This could be by taking hormone replacement therapy (HRT) or the [contraceptive pill](https://www.livi.co.uk/medical-advice/contraception/birth-control-pill/). 

A doctor might recommend that you take treatment until at least the average age of menopause, which is around 51. This is to help relieve your symptoms and lower your risk of developing certain health conditions.

You might not be able to take any kind of hormonal treatment if you’ve had certain types of cancer, like some [breast cancers](https://www.livi.co.uk/medical-advice/breast-cancer/). 

## Can you have children after early menopause?

Early menopause can affect your ability to get pregnant. Any impact on your fertility can be upsetting, even if you weren’t planning to have children. 

If you have POI, you may still be able to get pregnant with IVF using donor eggs or your own eggs if you’ve frozen them. Around [5% to 10% of women](https://www.msdmanuals.com/en-gb/professional/gynecology-and-obstetrics/menstrual-abnormalities/primary-ovarian-insufficiency) with POI get pregnant naturally.

## What support is there for early menopause?

It can be challenging to go through menopause at any age. Early menopause may also come as a shock. Nearly three-quarters of women experience some sort of [mental health impact during menopause](https://www.livi.co.uk/your-health/lets-talk-about-menopause-and-mental-health/). Treat yourself with extra compassion and self-care during this time. Opening up to others around you can also be really helpful. 

## When should I speak to a doctor?

If you’re under 45 and your periods have been getting less frequent or stopping altogether, speak to a doctor.

__This article was medically reviewed by Dr Bryony Henderson, Lead GP at Livi.__

livi.co.uk > Your health > What is early menopause?

What is early menopause

Around 5 in 100 women begin menopause early. But what counts as early and what does it mean for your health?

kry.co.uk > Your health > Meta info > What is early menopause?

What is early menopause? | Kry UK

What is early menopause?

You know you need to keep your hamstrings, abdominals and biceps strong. But just as you exercise your other muscles, it’s important to do regular pelvic floor exercises too. 

Although you can’t see your pelvic floor muscles, their strength plays a key role in your bladder and bowel function, your sex life and for women, your experience of childbirth and beyond. 

Here's what you need to know about strengthening your pelvic floor.

## Where exactly is my pelvic floor?

Your pelvic floor is made up of a group of muscles that lie across the base of your pelvis, stretching from the tailbone (coccyx, at the bottom of the spine) to the pubic bone at the front, and between the bones that you sit on. These muscles support and protect the pelvic organs (the bladder, bowel and uterus)  when you’re standing, walking, bending, or lifting. 

Together with the abdominal muscles, your pelvic floor is important for posture and to support your spine. Strong muscles prevent urine from leaking from your bladder. These muscles relax when you go for a pee or open your bowels, and they tighten again afterwards. Strong, healthy pelvic floor muscles can also help enhance sensation and enjoyment during sex. 

You can feel your pelvic floor muscles if you try and stop the flow of pee when you go to the toilet. Or, for women, pretend to tighten your vagina around a tampon.  

## What causes a weak pelvic floor?

Just like any muscle, your pelvic floor will naturally weaken over time. But there are many other reasons why your pelvic floor muscles may become weak, overstretched, too tight or torn. 

Some of the things that can weaken your pelvic floor include pregnancy and childbirth, especially if you had an episiotomy or tearing and the hormone changes associated with menopause. Chronic constipation, being overweight or overexercise may also play a part.

## What are the signs that I have a weak pelvic floor?

Some of the signs that it would be helpful to strengthen your pelvic floor include: 

- Leaking urine when you laugh, cough, sneeze, jump, run, walk, exercise or during sex
- A sudden and urgent need to pee or have a bowel movement, that may include leaking
- [Going to the toilet too often](/your-health/urinary-frequency-constant-need-to-pee/) (more than 8 times a day)
- Regularly getting up at night to pee
- Decreased satisfaction during sexual intercourse or painful sex
- A feeling of heaviness, as if something was bearing down, in the pelvis or abdomen
- [Lower back pain](/your-health/what-can-help-my-lower-back-pain-a-doctors-tips/)

## Is it normal to pee every 30 minutes?

It’s normal to empty your bladder 5-8 times a day, according to the NHS.  But, if you’re peeing more frequently, particularly if it’s every 30 minutes, this suggests there may be an underlying problem like a [urinary tract infection (UTI)](/your-health/utis-your-questions-answered/) or overactive bladder syndrome. Or, it could be a sign of diabetes,  particularly if you also have other symptoms like feeling thirsty, tiredness, itching, blurred vision or cuts and wounds that are slow to heal. Talk to a doctor if you’re concerned.

## What if I pee when I laugh or sneeze?

If you leak urine when your bladder is put under sudden extra pressure, you may have stress incontinence. This may happen when you laugh, sneeze, cough or exercise. Normally when you laugh or sneeze, your pelvic floor muscles contract to prevent urine from leaking.  But when muscles are weak, they’re not strong enough to counteract the pressure. 

Stress incontinence affects around 40% of women and is more common after the age of 40 (1 in 5 have it to some degree).  The most common reason for stress incontinence in men is weak pelvic floor muscles due to treatment for[ prostate cancer](/your-health/prostate-cancer-a-doctors-guide/). 

## Can having a stronger pelvic floor make a difference to my bladder?

Strengthening your pelvic floor muscles is helpful and effective for stress and urinary incontinence. It also helps keep your sex life healthy, increasing sensitivity, leading to stronger orgasms and helping to reduce the symptoms of e[rectile dysfunction in men](/your-health/erection-problems-a-doctors-guide-to-getting-help/). 

## Can I prevent pelvic floor or bladder problems later in life?

It’s not always possible to prevent pelvic floor or bladder problems especially if, for example, you’ve sustained damage in childbirth. But leading a healthy lifestyle can help to keep your pelvic muscles healthy. Here are some changes you can make to help prevent leaks:

- Practise daily pelvic floor exercises and keep active
- Eat a healthy diet
- Drink plenty of water as it helps to eliminate waste through the bladder and bowels (constipation strains the pelvic muscles, making them weaker)
- Lose excess weight, to reduce pressure on the pelvic floor
- Stop smoking, as it can lead to coughing, which can stress pelvic floor muscles 
- Avoid lifting heavy objects. If you do lift anything, always tighten your pelvic floor muscles before and after the lift 
- Avoid high-impact exercise like jumping or running if you have weak pelvic floor muscles 
- Take your time and make sure you empty your bladder completely each time you go to the toilet
- If you’re about to cough or sneeze, tighten your pelvic floor muscles

## What are the best pelvic floor exercises?

Pelvic floor exercises are also known as Kegel’s exercises because they were originally developed by American gynaecologist Arthur Kegel, in the 1940s, as a non-surgical way to help women control urine leaks by strengthening weak pelvic floor muscles. They also work for men.

## 3 daily pelvic floor exercises

### __Exercise 1: Sit and squeeze__
- Sit comfortably and squeeze your pelvic floor muscles 10–15 times. Imagine you’re sitting on a marble and tighten your muscles as if lifting the marble
- Don’t hold your breath or tighten your stomach, bottom or thigh muscles. Instead, breathe deeply and slowly
- With practice, try holding each squeeze for a few seconds. Have a rest between each one for a second or two
- Do these pelvic floor exercises for a few minutes every day and gradually add extra squeezes each week 

### __Exercise 2: Lie and tighten__
- Lie on your back with feet flat on the floor and knees bent. Alternatively, sit in a chair with your hands on your thighs, bending forwards slightly
- Tighten your pelvic floor muscles, squeeze, lift and hold for the count of 5 or as long as you can that feels comfortable. It’s important not to overdo it when you first start to do the exercises. Over a few weeks, gradually increase the time you squeeze, lift and hold to 10 seconds
- Let go and slowly count to 5. Repeat the cycle 5 times
- Try to do the pelvic floor exercises 3 times a day. But, it’s fine if you can only manage once or twice a day to begin with. The main thing is to practise these exercises every day 

### __Exercise 3: Quick tone-up__
- Squeeze muscles and let go — repeat 10 times
- Practise this anytime, for example while you’re waiting for the kettle to boil or standing in a queue 

## Should I talk to a doctor?

Talk to a doctor if you start to experience urinary or faecal incontinence or if you suspect you might have pelvic organ prolapse. Your doctor will arrange for tests and examinations to determine the cause and severity of the problem and advise you on the best treatments. 

Depending on your symptoms, they may refer you to a specialist physiotherapist for pelvic muscle training as a first point of call. This can be very helpful, for example in managing stress incontinence. If you suffer from urinary incontinence and pelvic floor exercises don’t help, you may need more specialist treatment  such as bladder training, medication or surgery. 

Likewise, if you have pelvic organ prolapse, your doctor will discuss the best options for you. These may include hormone treatment, pessaries or surgery. 

## Can men have weak pelvic floors?

Pelvic floor dysfunction affects more women than men, but it can affect men too. A weak pelvic floor can lead to urinary and faecal incontinence, pelvic pain and sexual dysfunction such as erectile dysfunction, premature ejaculation or reduced penile sensation.  

Common causes of pelvic floor dysfunction in men include ageing, lack of exercise, surgery for prostate cancer and being overweight. Male pelvic floor function is involved in coordinating ejaculation and pelvic floor therapy has been shown to improve control (over ejaculation).  

Pelvic floor muscle exercises may also be beneficial as a relevant component for erectile dysfunction.  Always talk to a doctor if you have any concerns like pelvic pain, sexual dysfunction or pelvic floor weakness after surgery.

__This article has been medically approved by Dr Rhianna McClymont, Kry Lead GP.__


kry.co.uk  >    article page  >   CTA

Speak to a GP about vitamins

Kry.co.uk > Your health > How to exercise weak pelvic floor muscles

How to exercise weak pelvic floor muscles

If your pelvic floor muscles are weakened it can cause issues with incontinence. Find out the symptoms and solutions from a Kry women’s health specialist

Pelvic floor exercises to strengthen a weak pelvic floor | Kry UK

kry.co.uk > Your health > Articles

All articles

See a KRY GP download app

Your health 

Kry UK

Kry is Europe’s leading digital healthcare provider. We combine digital technology with clinical expertise to help NHS services and health insurers solve the biggest challenges in healthcare.