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

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Your health | KRY

Burns and scalds are damage to the skin caused by heat. They can be painful and frightening, though the majority of burns are mild and can be treated at home or with the help of a pharmacist or doctor.

‘The difference between burns and scalds is that scalds are caused by wet things like boiling water in a kettle, and burns are caused by dry heat, like from an iron or flame,’ explains Dr Nikki Ramskill, a Livi GP. They’re both treated the same way. 

## What should I do if I have a burn?

- __Get away from the heat source__. Move as quickly and as safely as possible
- __Remove any clothing or jewellery near the burnt skin.__ Don’t remove anything that’s stuck to the skin, as this could cause more damage
- __Cool the burn.__ Hold it under cool, running water for at least 20 minutes
- __If the burn is large, keep warm.__ Wrap up in a blanket while you’re cooling the burn to prevent hypothermia. Go to A&E if the burn is larger than your hand
- __If your face or eyes are burnt, sit up for as long as possible.__ This helps reduce swelling. Go to A&E for any burns to the eyes and face
- __Relieve pain if necessary.__ Use paracetamol or ibuprofen

There are a few other points to remember: 

- __Never use ice or ice-cold water to cool a burn.__ Burning your skin may expose deeper layers that are more sensitive to cold temperatures. If you’ve had a large or severe burn, ice can lower your body temperature too far and potentially cause hypothermia. 
- __Avoid creams or ointments.__ Covering the burn in creams may slow the cooling process.
- __If you have a chemical burn, take a photo of the chemical.__ Show the doctors the photo in A&E so they know how to treat it.
- __Do not pop any blisters that form.__ 

## When should I go to A&E with a burn or scald?

You should also go to A&E if:

- The burn is larger than your hand
- Your skin is white or charred
- The burns are on your face, genitals, hands, arms, feet or legs and cause blisters
- You’ve had a chemical or electrical burn
- You have other injuries or have lost blood 
- You’ve inhaled smoke
- You’re pregnant
- You’re over the age of 60 
- Your child was burned 
- You have a serious medical condition like HIV, cancer, diabetes, or heart, lung or liver disease

If you or someone else has been burnt and is bleeding, having trouble breathing or is going into shock, call 999.

## When should I speak to a doctor about a burn or scald?

Even if you don’t need emergency care after burning yourself, it can be a good idea to make an appointment to see a doctor or nurse if:

- You need reassurance that it’s OK to treat your burn at home
- There’s worsening redness on your skin
- The pain is getting worse
- There’s pus coming from the burn
- You need advice on how to treat it

## What are the different types of burns?

### Superficial (first-degree burn) 
A burn that only affects the outer layer of the skin (the epidermis). These look red and feel dry, but don’t form blisters. 

Red and painful skin can be scary, but this is usually a sign that the burn hasn’t gone very deep into the tissues.

### Superficial partial-thickness (second-degree burn)
A burn that affects the epidermis and extends into the superficial dermis. These burns are usually very painful and typically form blisters within 24 hours. 

### Deep partial-thickness (second-degree burn)
These burns extend even deeper into the dermis, and they may not be as painful. 

### Full-thickness (third-degree and fourth-degree burns)
This affects all three layers of the skin, including the deepest layer (the hypodermis). The skin might look white, grey or charred and black. 

‘Not being able to feel your burn suggests the deepest layers of your skin have been affected and your nerve endings have been damaged by the heat,’ says Dr Ramskill. This is very serious and always requires urgent medical attention.

Burns can also be [categorised based on the cause](https://www.hopkinsmedicine.org/health/conditions-and-diseases/burns):  thermal burns, radiation burns, chemical burns or electrical burns.

## What’s a burn blister? 

A burn blister is a separation between layers of your skin that contains a clear fluid called serum. They form over a burnt area of skin to protect it. ‘Don’t pop any blisters,’ says Dr Ramskill. ‘Keep the skin clean and take painkillers as needed.’

## Should I cover a burn or let it breathe?

‘Covering the burn keeps the area moist and reduces pain from air blowing over the burn. For mild burns, you can apply a blister plaster,’ says Dr Ramskill. ‘Make sure that any dressings you apply are non-adhesive and suitable for burns.’

As your burn becomes less painful, it doesn’t need to be covered unless you’re worried about catching and bursting a blister. Avoid using any topical cream for burns unless a doctor advises you to.

If you’re given a dressing at a hospital, it will need changing after 48 hours, then every 3 to 5 days or[ whenever it gets wet](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC428524/).  

## What are the signs that a burn is infected?

The skin around infected burns or the burn blister may turn increasingly red and become painful. Feeling sweaty, clammy or flu-like can also be signs of a serious infection, and you might notice pus– a sticky, yellow substance – coming from the burn wound. 

‘Monitor how the skin looks underneath the dressing regularly,’ says Dr Ramskill. If you notice any signs of infection, seek medical advice. 

## How long does it take for a burn to heal?

### Mild burns: about a week
‘The fluid will usually drain away during the first few days,’ says Dr Ramskill. ‘The roof of the blister will protect the area while a new layer of skin forms underneath, and eventually, the blistered skin will peel away.’

### Severe burns: 2 weeks to several months. 
‘If your burn is severe enough that you went to hospital and received dressings, it can take longer for the burn to heal,’ says Dr Ramskill. Severe and deep burns can take months or even years to heal and sometimes require skin grafts.

‘It can take time to recover both physically and emotionally from a bad burn,’ says Dr Ramskill. ‘Bad burns in children can sometimes be emotionally scarring for caregivers as well. If you’re struggling, seek help from support groups or go through talking therapy to come to terms with what’s happened.’ 

You can also[ talk to a doctor](https://www.livi.co.uk/your-health/talking-about-mental-health-with-a-gp/)or a psychologist to get help. 

__This article has been medically reviewed by Dr Nikki Ramskill, a Livi GP__


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Livi.co.uk > Your health > How to treat burns and scalds – a doctor’s first aid tips

How to treat burns and scalds – a doctor’s first aid tips

What should you do if you get burnt and when should you see a doctor? Read our guide to treating burns and scalds and learn about the signs of infection

Kry.co.uk > Your health > How to treat burns and scalds – a doctor’s first aid tips

How to treat burns and scalds and when to seek help | Kry 

Stomach pain is a common symptom, with around [7 in 10 people reporting tummy troubles every year](https://journals.sagepub.com/doi/full/10.1177/2050640618821804). 

‘Most of the time stomach pain is nothing to worry about and will go away on its own, or you might need to take extra steps to ease your symptoms,’ says Dr Roshaan Saloojee, a Kry GP. ‘Very occasionally, though, stomach pain can be a cause for concern.’

## Stomach cramps with bloating 

Trapped wind can cause stomach cramps and make you feel full, tight or swollen across your stomach. [Irritable bowel syndrome (IBS)](/medical-advice/digestive-problems/irritable-bowel-syndrome-ibs/) can also cause painful bloating.

‘Bloating, farting and trapped wind happen when you have more gas than usual,’ says Dr Saloojee. ‘Sometimes this is from swallowing extra air if you eat quickly, chew gum or suck sweets. Gas also comes from foods that are harder to digest, like lentils, leafy greens or vegetables – particularly if you have IBS, are sensitive to fibre or are lactose intolerant.’ 

### When to talk to a doctor 

Stomach cramps and wind usually go away in a couple of hours or days. Speak to a doctor if: 

- Your symptoms last longer than this, come back or get worse 
- You notice changes to your poo or toilet habits, including blood in your poo
- You have unexplained weight loss

## Dull, persistent stomach pain 

Longer-lasting tummy ache can have lots of different causes, including: 

- [Constipation ](/medical-advice/digestive-problems/constipation/)
- [Heartburn](/medical-advice/digestive-problems/acid-reflux/) and indigestion
- [IBS](/medical-advice/digestive-problems/irritable-bowel-syndrome-ibs/) 
- [Gastritis](/medical-advice/digestive-problems/irritable-bowel-syndrome-ibs/) or an inflamed stomach
- A [urinary tract infection](/your-health/utis-your-questions-answered/) (UTI) 

### When to talk to a doctor 

‘Mild stomach pain with no other symptoms is usually nothing to worry about and should get better on its own or with a few lifestyle changes,’ says Dr Saloojee. ‘But speak to a doctor if it lasts longer than a few days or you have any other symptoms, such as feeling generally unwell.’

## Sudden stomach cramps with diarrhoea 

Stomach pain with diarrhoea and/or vomiting might be the result of a [stomach infection](/medical-advice/digestive-problems/gastroenteritis/), such as: 

- Food poisoning
- A virus like stomach flu or norovirus 
- [Diverticulitis](/medical-advice/digestive-problems/diverticular-disease/) 

‘The usual culprits for a tummy bug are eating unusual or spoiled food and reheating leftover food. You might have severe diarrhoea, vomiting, fever and cramps, which are at their worst in the first 2 days,’ says Dr Saloojee.

‘Make sure you drink plenty of fluids – drink 6-8 glasses of water slowly throughout the day. You can also put rehydration salts in your drink to help you stay hydrated.’

### When to talk to a doctor 

‘Stomach bugs usually clear up in a few days but can sometimes last up to 14 days,’ says Dr Saloojee. It’s best to speak to a doctor if:

- Your diarrhoea hasn’t improved after 7 days 
- You have diarrhoea more than 6 times a day 
- You notice blood in your poo
- You’ve been vomiting for more than 2 days 
- You have [signs of dehydration](/your-health/why-is-hydration-so-important-a-doctors-guide/) 

## Severe stomach pain 

If you’re in so much pain that you can’t move around, sleep or do normal activities, get medical advice immediately. 

Severe stomach pain can be caused by: 

- [Appendicitis](/medical-advice/digestive-problems/appendicitis/) 
- [Kidney stones ](/medical-advice/urology/kidney-stones/)
- Gallstones 
- A stomach ulcer 
- [Diverticulitis](/medical-advice/digestive-problems/diverticular-disease/) 
- A bowel obstruction 

‘The pain might start suddenly or gradually become severe,’ explains Dr Saloojee. 

### When to talk to a doctor 

‘Intense pain is a sign that something is wrong. Speak to a doctor as soon as possible, call 111 or go to A&E,’ emphasises Dr Saloojee.

## Stomach pain with constipation

[Constipation](/medical-advice/digestive-problems/constipation/) is when you’re pooing less than 3 times a week. 

‘If you think you’re constipated, first try eating more fruit and veg, drinking more water and doing some light exercise to get the bowel moving,’ says Dr Saloojee. 

‘You can also try over-the-counter laxatives such as senna or lactulose.’

### When to talk to a doctor 

‘If you have difficulty passing wind for more than a day, speak to a medical professional straight away as this may be a sign of a blockage in the bowel,’ says Dr Saloojee. ‘Also, if you’re still unable to poo after trying some simple solutions, talk to a doctor for more advice.’

## Lower stomach pain 

Pain in your lower stomach might come from your reproductive or urinary system. If you have a female reproductive system, the pain may be caused by: 

- Period pains 
- [Fibroids](/medical-advice/gynaecology/fibroids/) or [cysts](/medical-advice/womens-health/ovarian-cyst/) 
- [Endometriosis](/medical-advice/womens-health/endometriosis/) 
- An ectopic pregnancy 
- Pelvic inflammatory disease 

Other causes include:

- [UTIs](/your-health/utis-your-questions-answered/)
- [Bladder stones](/medical-advice/urology/bladder-stones/)
- [Sexually transmitted infections](/your-health/10-common-stis-and-their-treaments/)

### When to talk to a doctor 

‘Speak to a doctor if the pain won’t go away or you notice symptoms like burning while you pee, unusual vaginal discharge, pain during sex or heavy periods,’ says Dr Saloojee.

## Stomach pain with heartburn 

Heartburn, indigestion or acid reflux can cause pain in your upper stomach, burning in your chest and a sour taste in your mouth. It can also feel like pressure in your chest or tummy that gets better when you burp. 

‘Heartburn is commonly caused by overeating, diet, alcohol or stress,’ explains Dr Saloojee. ‘You can treat it with over the counter medicine and by avoiding things that trigger your symptoms.’ 

It can also help to eat smaller meals and avoid eating late at night or lying down after eating. 

### When to talk to a doctor 

‘On its own, heartburn is normal from time to time. But if it happens frequently and you have symptoms like fatigue, difficulty swallowing, vomiting, a lump in your stomach or weight loss, speak to a doctor,’ says Dr Saloojee. 

## Stomach pain during pregnancy 

‘Stomach pains or cramps can be normal in pregnancy. If they’re mild and go away on their own, they’re probably caused by constipation, wind, indigestion or ligament pain,’ explains Dr Saloojee. 

Speak to your midwife or a doctor right away if: 

- The pain feels like cramps that come and go (you may be going into labour)
- The pain persists or gets worse 
- You have pain when you pass urine or back pain
- You notice unusual vaginal discharge or bleeding

## What can help with stomach pain? 

You don’t always have to simply put up with a stomach ache. These are things you can do to ease mild or moderate stomach pain at home:

- Avoid trigger foods 
- Use a heat pad on your tummy for 15 minutes 
- Take paracetamol – avoid ibuprofen, which can aggravate the stomach
- Have a warm bath 
- Gently massage your stomach in slow, circular motions 
- Try light exercise like walking, stretching or yoga 
- Sip water throughout the day
- Eat smaller meals
- Drink peppermint or chamomile tea 
- Take over the counter medicine: antacids for heartburn, laxatives for constipation or hyoscine butylbromide tablets and mebeverine for cramps and bloating

[Eating a bland diet](https://www.ncbi.nlm.nih.gov/books/NBK538142/) (avoiding spicy, raw or fatty food, onions, garlic, alcohol, caffeine and fizzy drinks) can help to ease many different stomach problems.  
If stomach pain is a regular problem for you, try keeping a food and symptom diary to narrow down [what might be causing your symptoms](/your-health/whats-causing-your-gas-and-flatulence/).

## When is stomach pain serious? 

Occasionally, stomach pain is a sign of something serious.

Seek medical advice urgently if: 

- Your stomach pain is severe
- The pain started quickly 
- It’s painful to touch your stomach 
- Your stomach feels hard
- You’re vomiting blood (it can look like coffee grounds) 
- Your poo is bloody or black, sticky and unusually smelly
- You’re unable to pee 
- You can’t poo or fart 
- You have chest pain or trouble breathing 
- You have diabetes and are vomiting
- You feel dizzy or have fainted/collapsed 

A doctor will ask you about your symptoms and may do a physical exam, refer you for tests on your poo or blood, and make a plan to help you relieve your stomach pain. 

Serious conditions like [Crohn’s disease](/medical-advice/digestive-problems/crohns-disease/), irritable bowel disease, [coeliac disease](/medical-advice/digestive-problems/coeliac-disease/) or cancer can also cause stomach pain. This type of pain is usually chronic (lasting more than 3 months) and you’ll probably notice other symptoms like changes to your toilet habits and feeling tired or unwell. 

Some people have chronic stomach pain with no obvious cause. [This may affect around 2% of people each year](https://pubmed.ncbi.nlm.nih.gov/17681003/). 

__This article has been medically approved by Dr Roshaan Saloojee, a Kry GP.__


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Kry.co.uk > Your health > When should I see a doctor about stomach pain?

When should I see a doctor about stomach pain?

Most of the time, stomach pain is nothing to worry about – but very occasionally, it’s a cause for concern. Here's what to do if you've got a stomach ache

When should I see a doctor about stomach pain? | Kry

Having negative thoughts is more common than you’d think. Everyone experiences them now and again. But in some cases, they can seriously affect the way you see yourself and influence how you behave. 

Therapy can be helpful for changing unhelpful thinking styles, but you can also learn strategies and techniques yourself to cope better.

## What are negative thoughts? 

‘Negative thoughts can be about yourself, the people around you and your surroundings. They may sometimes be irrational,’ explains Eräkallio. They can[ affect your mood](https://journals.sagepub.com/doi/10.1002/per.855), leaving you feeling sad or stressed, and can even contribute to symptoms of [anxiety](/your-health/need-help-for-anxiety-here-are-your-questions-answered/) and [depression](/your-health/help-for-depression-7-daily-tools-to-improve-your-mood/).

We tend to dwell more on negative events than positive ones. This is called negativity bias and can also lead to unhelpful patterns of thinking. 

## How do I recognise when I’m having negative thoughts? 

‘The first step to identifying negative thoughts is to become more aware,’ Eräkallio says. By recognising these negative thought patterns, you can pay attention to the impact they have on your emotions and behaviour and start to lessen their power.

Some of the most common negative thought examples include:

__Catastrophising__ – assuming the worst-case scenario will happen and underestimating your ability to handle it

__Overgeneralisation__ – drawing general conclusions by applying one experience you had to all your future experiences 

__Mind reading__ – assuming you know what someone else is thinking, without checking whether it’s true

__Black and white thinking__ – believing things can only go one of two ways, for instance, ‘good’ or ‘bad’. There are only extremes, nothing in the middle

__Emotional reasoning__ – taking your emotions as fact 

__Negative filtering__ – focusing only on the negative without seeing any of the positive or neutral aspects

__Should statements__– statements you make about what you ‘must’ do or ‘should’ do, even though they’re unlikely to happen

__Labelling__ – judging yourself or others based on one instance or experience 

‘Try to think about the specific situations where negative thoughts most often appear,’ Eräkallio suggests. ‘Writing down unhelpful thoughts can help you identify negative thinking styles, view them more clearly and gain a greater perspective on how your thoughts (rather than situations) cause your emotional reactions.’

## 5 strategies for dealing and coping with negative thoughts 

### 1. Challenge your thoughts 

‘We usually don’t objectively examine our own thoughts – as humans, we can find this difficult. But by starting to challenge your thoughts rather than immediately accepting them, you can start to explore alternatives that are more realistic and helpful,’ Eräkallio says. So, ask yourself: 

- Is this fact or an opinion? 
- What evidence do I have for and against this thought?
- Can I reframe this thought? 
- What is the worst-case scenario? How would I handle this?
- How realistic do I think this thought is?

Challenging thoughts can be difficult, but over time – and with practice – rational thoughts should come more naturally. 

### 2. Label your thoughts 

[Research suggests](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1483905/) that the more you try to suppress a thought, the more likely it is to resurface. This is also referred to as ‘thought rebounding’. 

Rather than focusing on trying to stop your negative thoughts, try observing and objectively describing them instead. 

One technique you can try is labelling your behaviour instead of labelling yourself. For instance, instead of calling yourself unintelligent, learn to label the thought: ‘I’m having a thought that I’m unintelligent.’

‘This exercise can help you stop the cycle of negative thoughts and let you practise seeing them as simply thoughts rather than something that defines you,’ says Eräkallio. 

### 3. Notice how your thoughts affect your behaviour 

Negative thought patterns may feel so overwhelming and upsetting that they can influence how you act. 

‘Identify a specific situation and try writing down the thoughts you had at the time and how they made you feel. Then reflect on how these thoughts made you behave in the situation,’ suggests Eräkallio.

‘The aim is to become more aware of these internal processes and prepare us for similar situations in the future.’ 

### 4. Get moving 

Exercise is a great way to reset your mindset. ‘No medication or psychological treatment has the same protective health effects on your brain, mindset and thinking as physical activity,’ explains Eräkallio. 

A daily walk or run or taking up a new sport could help you change your outloo

### 5. Discover the benefits of mindfulness 

Practising mindfulness meditation is a good way to become more conscious of your thoughts and feelings. As well as helping you focus on the present moment, mindfulness is also an effective way to silence a constant stream of thoughts, concerns and judgments. [One study](https://www.frontiersin.org/articles/10.3389/fnhum.2016.00451/full) found that mindfulness can help regulate negative feelings and improve your emotional health.

## How can a psychologist or therapist help with negative thoughts? 

‘A psychologist can help you identify and become more aware of your negative thinking patterns. More importantly, they can examine and challenge your thoughts with you,’ says Eräkallio. 

[Cognitive behavioural therapy (CBT)](/your-health/5-phobias-cbt-can-help-with/) can be effective at disrupting negative thinking patterns. CBT explores how your thoughts, feelings, physical symptoms and behaviours are interrelated and how they impact your everyday life. It can help you recognise unhelpful thinking styles so you can challenge them. 

## When should I speak to a therapist?

If you’re struggling with negative thoughts, see a therapist who can help and refer you for further support. It’s always a good idea to book an appointment if your negative thoughts:

- Interfere with your daily life, including work, study and relationships
- Cause you to feel anxious, stressed or depressed
- Affect your ability to concentrate 
- Make it hard for you to go to sleep or to get up 

__This article has been medically reviewed by Kry psychologist Camilla Eräkallio.__


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Kry.co.uk > Your health > 5 ways to deal with negative thoughts now

5 ways to deal with negative thoughts now

Negative thought patterns can affect the way we see ourselves and the world around us. Discover how to recognise unhelpful thoughts and some strategies for how to deal with them.

5 ways to deal with negative thoughts | Kry

Everyday mental wellbeing

5 ways to deal with negative thoughts now 

In the UK, around twice as many people are living with heart and circulatory diseases (known as CVD) than with cancer and Alzheimer’s disease combined. One of the biggest risk factors for CVD is high cholesterol. 

The good news is there are lots of simple lifestyle steps you can take to help lower your cholesterol levels.

Dr McClymont explains why cholesterol levels are important and what you can do to stay healthy.

## Why is high cholesterol so unhealthy?

Cholesterol is a fat that’s made in the liver. It’s also found in some foods like eggs. But current research shows that for most healthy people, cholesterol in food has a much smaller effect on blood levels of total cholesterol. It also shows the effects of saturated fats in foods like butter and fatty meats are more harmful.

Cholesterol itself is not unhealthy and every cell in your body needs it. But if there’s too much circulating in your blood, it can clog up and damage blood vessels. Experts agree that reducing cholesterol can be a crucial step in reducing your risk of CVD.

## Who is at risk of high cholesterol?

‘Statistically, young men are more likely to have problems with high cholesterol than young women,’ says Dr McClymont.

‘However, after menopause, when women’s oestrogen levels start declining, they become more likely to have raised cholesterol levels, especially LDL cholesterol which is known as the ‘bad’ cholesterol.’

## Should I have my cholesterol checked?

There are not any obvious or visible high cholesterol symptoms, so getting tested is the easiest way to know for sure.

Your doctor can measure your cholesterol using a blood test. If you’re over 40, it will be tested using a finger prick test as part of your routine NHS Health Check (you should receive a letter from your doctor about this).

‘The NHS recommends everyone over the age of 40 has a cholesterol test,’ Dr McClymont says. But your heart disease risk depends on other factors as well. 

‘GPs will look at your age, sex, weight, blood pressure, history of diabetes and your family history of heart problems.’
Some genes are associated with high cholesterol and an inherited condition called familial hypercholesterolemia.

## What should your cholesterol be?

‘Aim for a total cholesterol of below 5mmol/l,’ Dr McClymont advises. 

‘But not all cholesterol is the same, she explains. HDL cholesterol is often described as ‘good cholesterol’ and thought to protect against heart disease, while ‘bad’ LDL cholesterol increases the risk. An easy way to remember which is which, is to think of HDL as happy and LDL as lousy.

‘An important aspect of cholesterol can be the ratio of total cholesterol (TC) to good cholesterol (HDL). Ideally, this should be as low as possible,’ Dr McClymont says. 

‘Calculate this by dividing your TC number by your HDL number. So for example, if your TC is 4.5 mmol/L and HDL is 1.2 mmol/L, the ratio is 3.75. The lower the ratio, the lower your risk of heart disease.

## How to lower cholesterol through lifestyle changes

These simple changes to your diet and lifestyle have proven to lower cholesterol levels.

### 1.	Cut back on saturated fats

Eating a diet high in saturated fats increases the risk of high cholesterol. These fats are found in meat, cheese and other animal-based foods, as well as some vegetable oils like palm and coconut oil.

A review of the evidence, which looked at 15 studies with more than 56,000 participants, found cutting saturated fat intake reduced the risk of CVD by 17%.

Eating omega-3 fatty acids (found in oily fish like salmon and herring) may stop cholesterol from building up on artery walls so it can be helpful to include one serving a week in your diet. Remember there is different advice for women who are breastfeeding or pregnant and for children and babies.

Switching to unsaturated oils like rapeseed, sunflower and olive oils and reducing the amount of overall fats you use can help reduce your risk of CVD by 30%. Choosing leaner cuts of red meat (and eating less of it), and switching to low or lower-fat dairy products helps too. It’s also a good idea to grill, poach or steam food instead of frying, whenever you can.

### 2.	Eat more fibre

Studies show that eating 3g of soluble fibre a day — the amount you would get from 3 apples or 3 bowls of porridge (28g servings) — can help lower cholesterol.  

You can increase your fibre intake by eating more fruit, vegetables, wholegrain cereals, beans and other pulses, and switching to wholegrain pasta and bread.

Oats are another example of cholesterol reducing foods, because they contain natural sugars called beta-glucans, proven to help lower cholesterol.

### 3.	Get moving

Studies show that doing 120 minutes a week of aerobic exercise helps to increase protective HDL cholesterol and reduces the risk of CVD by 5.1% in men and 7.6% in women.

Aerobic exercise is anything that gets your heart pumping and makes you out of breath. And, it can be done in small chunks throughout the day if more convenient.

### 4.	Quit smoking

Its proven that smokers have lower levels of healthy HDL cholesterol than non-smokers. But a rise in HDL cholesterol can occur less than 3 weeks after giving up smoking.

If you need help to quit smoking, there are lots of free resources available. Nicotine replacement products like patches or gum, for example, can help curb cigarette cravings and there are other options like support groups or one-to-one counselling. 

### 5.	Swap the junk food for home cooking

Home cooked foods are always the best option when considering a diet to reduce cholesterol. Processed foods are often high in saturated fats, refined grains, added sugars and salt, which all increase the risk of high cholesterol and CVD risk factors, like weight gain.

Cook from scratch wherever possible, and check food labels. As a general rule, the longer the list of ingredients, and the less familiar their names are as foods, the more highly processed the product will be.

### 6.	Consider a Mediterranean-inspired diet

A more plant-based Mediterranean style of eating has been shown to help reduce blood cholesterol by 13%-15%. This approach involves a variety of brightly coloured fruits, vegetables and wholegrains in your diet as well as healthy servings of fish and healthy fats like olive oil.

## What about cholesterol-lowering drugs?

If diet and lifestyle aren’t enough to reduce your cholesterol, your doctor may consider prescribing a statin. 

‘These drugs block the production of LDL cholesterol and are offered to anyone with a history of CVD, or who hasn’t managed to reduce their risk with lifestyle changes,’ says Dr McClymont.

While some may experience side effects to statins like muscle aches, many of these people can tolerate another statin better. 

Always speak to a GP if you are experiencing problems with your medication.


Speak to a GP about your cholesterol

Kry.co.uk > Your health > How to lower your cholesterol

how to lower your cholesterol

Your cholesterol measurement is a key indicator of your heart disease risk. If it's on the high side, there are proven lifestyle measures that can help reduce it. Dr Rhianna McClymont, Kry Lead GP, shares her advice

How to lower your cholesterol – a doctor's guide | Kry

Reviewer > Dr Rhianna

IMG 20200730 224911 865[33] (1)

Dr Rhianna McClymont

Lead GP at Kry

General health

General health and seasonal

How to lower your cholesterol – a doctor's guide

Your tongue has between [2,000 and 4,000 taste buds](https://www.ncbi.nlm.nih.gov/books/NBK279408/), allowing you to appreciate the taste of food. Your tongue is also home to the majority of bacteria that live in your mouth – some promote health, while others can cause issues.

Your tongue can change colour depending on a variety of factors, including what you’ve eaten and [whether you’re hydrated](/your-health/why-is-hydration-so-important-a-doctors-guide/). 

## What does a healthy tongue look like?

‘A healthy tongue is pink, moist and doesn’t feel painful. The surface of your tongue is covered with little nodules and bumps called papillae, which contain our taste buds,’ explains Dr Nikki Ramskill, a Kry GP. 

![Tongue chart UK](//images.ctfassets.net/h8qzhh7m9m8u/69WHmaKdjPLJECJrCZnnP9/ea0d9d31b5ef900539839c6cfea18c0e/Tongue_chart_UK.png)

## 1. If your tongue has a yellow coating… 

‘A yellow or brown coating on your tongue might be caused by a build-up of bacteria from poor oral hygiene, smoking, alcohol or drinking lots of coffee or black tea,’ says Dr Ramskill. 

A dry mouth and using products with thymol, menthol, witch hazel, peroxides, eucalyptus or alcohol can also cause a yellow coating.

If your face, eyes and tongue look yellow, speak to a doctor as this might be caused by problems with your liver or gallbladder. 

## 2. If your tongue is white… 

The most common reasons for this include:

### Oral thrush
‘If your tongue has a thick white coating, it could be oral thrush – a yeast infection of your mouth’s mucous membranes,’ says Dr Ramskill. Oral thrush is common in babies. If you’re breastfeeding, your baby can pass the infection from their mouth to your nipples. It can be easily treated with over-the-counter antifungal medicines. 

### Lichen planus
This is a disease that causes inflammation inside your mouth or other parts of your body. ‘It looks like you have a white lacy pattern on your tongue and inside the mouth,’ explains Dr Ramskill.

### Leukoplakia
Leukoplakia appears as a white patch on your tongue, gums or the inside of your cheeks and is most commonly caused by smoking. Speak to a doctor if you have this, as there’s a slight risk it can develop into [mouth cancer ](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566351/)over time. 

## 3. If your tongue is sore and bumpy… 

‘Bumps on the back of the tongue are normal. These are just papillae, which are essential to the normal function of your tongue,’ says Dr Ramskill. 

‘If you have a sore, bumpy tongue, it could be a sign of infection or inflammation caused by trauma – you might have accidentally bitten your tongue or burnt it on a hot drink or food. Use over-the-counter medications, like paracetamol and ibuprofen, to help with pain, or apply a gel directly to the sore area.’

## 4. If you have tongue ulcers…

Mouth ulcers – sometimes referred to as canker sores – can appear on your tongue. They might be caused by biting your tongue or damage caused by a toothbrush. Pregnancy and certain medicines can cause ulcers, too.

[Feeling stressed](/your-health/physical-signs-of-stress-on-the-body/), run down and anxious are also common causes of ulcers. A [recent study](https://www.nature.com/articles/s41467-019-08923-6) found a significant link between depressive symptoms and experiencing mouth ulcers. 

They usually clear up on their own within a few weeks, but if you have a particularly painful ulcer, try avoiding spicy, salty and acidic foods and toothpaste containing sodium lauryl sulphate.

‘A pharmacist can recommend a gel, spray or mouthwash to speed up the healing time. If you have a mouth ulcer that isn’t healing, get it checked by a doctor because in rare cases it can be a sign of mouth cancer,’ says Dr Ramskill.

## 5. If your tongue is swollen…

If your tongue is swollen, you may be experiencing[ glossitis](https://www.ncbi.nlm.nih.gov/books/NBK560627/) – an inflammation of the tongue. It can have several causes, including an allergic reaction, a dry mouth, injury or a nutritional deficiency. 

‘If your tongue swells after eating a certain food, seek medical advice straight away. The swelling can spread to the back of the throat and lead to breathing difficulties,’ explains Dr Ramskill. 

## 6. If your tongue is black and looks hairy…

A black, hairy-looking tongue is usually caused by a build-up of dead skin cells on the tips of the tongue’s papillae, which trap bacteria and food remnants. This may be due to poor oral hygiene, smoking, a dry mouth or eating a diet of mainly soft foods. 

Try tongue cleaning or scraping and flossing, and eat a healthy diet.

## 7. If your tongue is red…

Kawasaki disease is a rare but serious illness, most often seen in children, which causes a red, inflamed tongue. 

Bacterial infections like scarlet fever can also cause a bright red tongue, alongside a rash across the whole body, a sore throat and a fever. Vitamin B12, folic acid or iron deficiency can also cause a redder tongue.

## How can I look after my tongue health?

Looking after your tongue is as important as taking good care of your teeth if you want to maintain good oral health. Here’s how to do it:

__Drink plenty of water__ – staying hydrated helps wash away bacteria and food from your tongue and also helps to prevent a dry mouth, which increases your risk of fungal infections and tooth decay. 

__Clean your tongue__ – use a toothbrush, tongue scraper or cleaner. This helps remove bacteria and dead cells from the surface of the tongue, which may cause bad breath. 

__Give up smoking__ – it can irritate your tongue and contribute to conditions like leukoplakia.

__Chew sugar-free gum__ – this stimulates saliva production, which helps rinse away bacteria, clears food, reduces acid in your mouth and alleviates a dry mouth. 

## When should I see a doctor? 

If you have concerns about any of these symptoms and there isn’t an obvious temporary cause, speak to a doctor. Dr Ramskill advises you to seek health advice if: 

- You’re worried about the colour of your tongue or any changes in sensation
- You notice any lumps, bumps or sores on your tongue
- You have unexplained or severe tongue pain that continues for several days 
- You experience itchiness that gets worse and doesn’t go away
- You have a white patch in your mouth that hasn’t gone away for 2 weeks

Arrange an appointment with a dentist if you have any problems with your teeth or gums, like bleeding, painful or swollen gums or toothache. 

__This article has been medically reviewed by Dr Nikki Ramskill, a Kry GP__


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Kry.co.uk > Your health > What can your tongue tell you about your health?

What can your tongue tell you about your health?

The colour and texture of your tongue can say a lot about your health. It can give clues about what’s going on within your body, including nutritional deficiencies and illness

What can your tongue tell you about your health? | Kry

We’ve all experienced bad breath (also known as halitosis) at some point – from morning breath to the effects of spicy or pungent foods. If your breath smells, it can make you self-conscious and stressed, especially in social situations or when getting up close to a partner. 

Here are the main causes and the easy steps you can take to minimise bad breath.

## What’s the main cause of bad breath? 

Bad breath is usually caused by an excess of bacteria in your mouth, which produce smelly gases called volatile sulphur compounds. ‘These sulphur-producing bacteria normally live on the surface of your tongue and in your throat,’ says Dr Nikki Ramskill, a Livi GP. 

‘Lifestyle habits, illness and certain foods can make your breath smell because they encourage these bacteria to release odours. But if you can keep the bacteria in your mouth happy, you’re less likely to develop bad breath.’ 

If you regularly have bad breath, it could also be an indicator of a tooth problem or an underlying health condition. If you’re concerned, speak to a doctor or dentist, depending on your symptoms.

## What causes bad breath? 

### 1. Smelly foods
Foods like garlic, onions, chives and spices can cause bad breath. Garlic and onions are part of the same family of vegetables with sulphur-containing compounds, which gives them their flavour. 

‘After these foods have been digested, their compounds are absorbed into your bloodstream and carried to the lungs, which makes your breath start to smell,’ explains Dr Ramskill. 

### 2. Gum disease 
If you have persistent bad breath, it might be a sign of gum disease. ‘Gum disease can lead to bad breath due to the build-up of plaque along the gum line,’ explains Dr Ramskill. 

‘When food particles aren’t cleared away regularly, it allows bad breath-related bacteria to multiply and grow.’ 

### 3. Dry mouth 
A dry mouth often occurs when your production of saliva slows down. Saliva helps to cleanse your mouth by removing bacteria and leftover food particles, so a dry mouth can leave you prone to bad breath. 

You’ll naturally experience a drier mouth at night, because your salivary glands produce less saliva, leading to ‘morning breath’. 

And it can be a side effect of some medications, including the contraceptive pill, antidepressants and sleeping tablets. ‘It may also be due to alcohol, stress or [dehydration](https://www.livi.co.uk/your-health/why-is-hydration-so-important-a-doctors-guide/),’ says Dr Ramskill. 

### 4. An underlying health concern 
Conditions that can [affect your airways](https://www.ncbi.nlm.nih.gov/books/NBK534859/) may also affect the smell of your breath. These include:

- Asthma
- Cystic fibrosis
- Kidney failure
- Liver disease
- Postnasal drip
- Tonsillitis
- Sinusitis
- Bronchitis
- Pneumonia

Diabetes can also affect your breath. ‘Diabetes raises the glucose levels in your saliva, encouraging bacteria growth and bad breath. This can also lead to gum disease and tooth decay,’ Dr Ramskill says. 

If your breath smells fruity or like acetone, the chemical in nail polish remover, it could be a sign of [diabetic ketoacidosis](https://www.ncbi.nlm.nih.gov/books/NBK534848/). ‘This is caused by the body burning fat instead of glucose,’ says Dr Ramskill. ‘The ketones released by this process produce a waste product, which causes the smell.’

### 5. Acid reflux
Bad breath is a common symptom of chronic acid reflux or gastroesophageal reflux disease (GERD). ‘This is because the contents of your stomach – including stomach acid, bile and undigested food – flow back up into your oesophagus, the tube that takes food from your mouth to your stomach. This can cause a bitter or sour taste in your mouth,’ Dr Ramskill says. 

‘It can also be caused by a type of bacteria that infects your stomach, called Helicobacter pylori. If your bad breath is a new problem and you haven’t eaten something to cause the [acid reflux](https://www.livi.co.uk/medical-advice/digestive-problems/acid-reflux/), speak to a doctor. A doctor may request a stool test, which can detect these bacteria.’ 

### 6. Restrictive diets
Cutting down on carbohydrates and fasting can also lead to a distinct fruity or acetone-smelling breath. This is because it can cause the body to break down fat instead of carbohydrates to create energy, which produces chemicals called ketones that are released in your breath.

You may also develop a dry mouth in the early stages of dieting as your body loses water. 

### 7. Poor dental hygiene 
Perhaps the most common reason for bad breath, particularly in children, is poor [dental hygiene](https://www.ncbi.nlm.nih.gov/books/NBK534859/). Not brushing and flossing teeth daily can lead to an excess build-up of bacteria between the teeth and gums, causing bad breath. These bacteria can also cause gum disease and tooth decay.

### 8. Smoking 
As well as staining teeth, irritating gums and dulling taste buds, tobacco can also cause bad breath. ‘When you smoke, chemicals found in cigarettes stick to the surfaces of the teeth and gums – leading to more sulphur-releasing bacteria,’ says Dr Ramskill. 

## How do I get rid of bad breath? 
The good news is there are some easy ways to minimise bad breath. Here are Dr Ramskill’s tips: 

__Chew on fresh mint or parsley after a meal__
These can help neutralise the odours in your mouth caused by sulphur compounds. 

__Keep your teeth clean__
Gently brush your teeth and gums at least twice a day for 2 minutes with a toothpaste containing fluoride.

__Floss or use a tongue cleaner__
At least once a day, clean between your teeth with interdental brushes or floss, and gently brush your tongue with a tongue scraper or cleaner. One study found that using a toothbrush to brush the tongue in a cross pattern 6 times resulted in a [significant reduction in bacteria and halitosis](https://pubmed.ncbi.nlm.nih.gov/30970113/).

__Don’t rinse your mouth immediately after brushing__
This is because it will dilute the fluoride in the toothpaste and reduce its protective effects. You also shouldn’t eat or drink for 30 minutes after using a fluoride mouthwash.

__Chew on sugar-free gum between meals__
This can also prevent a dry mouth because it stimulates your salivary glands. 

Changing a few lifestyle habits can also help with bad breath:

__Drink plenty of water__
This will help prevent your mouth from becoming dry, and it will rinse away food particles between routine brushing.

__Give up smoking__
As well as preventing your teeth from staining, you’ll also have fresher breath. 

__Limit sugary foods and fizzy drinks__
Bacteria thrive on these to make acid, which contributes to tooth decay and erosion. 

__Have regular dental check-ups__
This will help to keep your mouth healthy and prevent dental problems from occurring.

## When should I see a doctor? 

‘If these remedies aren’t lasting or working, there’s likely to be an underlying reason,’ says Dr Ramskill. 

Speak to a doctor if: 
- You have bad breath that doesn’t go away after treating it yourself for a few weeks
- You have bad breath associated with other symptoms, such as acid reflux 
- You’re taking medication that could potentially cause bad breath

__This article has been medically approved by Dr Nikki Ramskill, a Livi GP.__


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Livi.co.uk > Your health > What’s causing my bad breath?

What’s causing my bad breath?

Bad breath is common and can affect even the most conscientious brushers and flossers. But what are the most common causes and how can you prevent and treat it?

Kry.co.uk > Your health > What’s causing my bad breath?

Having a stuffy or blocked nose isn’t just annoying – it also makes it harder to breathe easily and affects our sleep quality. So what’s the best way to clear the congestion, according to a doctor?

‘There are a few effective blocked nose remedies you can try at home,’ says Dr Ramskill, GP at Kry. ‘If they don’t give you relief, the next step would be to speak to a pharmacist or doctor about treatment options.’

## What causes a blocked nose?

Although it seems like your nose is bunged up, the feeling is usually caused by swelling inside the nasal lining, rather than mucus.

‘Every day, we breathe in up to 15,000 litres of air, which is full of invisible dust, pollen and viruses. Luckily, the immune system is good at quickly getting rid of them,’ explains Dr Ramskill. 

‘When it detects an unwanted visitor in the nose, the blood vessels swell, enabling white cells to come and tackle the problem. But the swelling can also block your nose.’

The most common causes of a blocked nose are:

- Nasal allergies, most commonly related to dust mites, pollen or animal fur
- A [cold](/medical-advice/infections/common-cold/)
- Flu
- [Coronavirus](/medical-advice/infections/coronavirus/) (Covid-19) 

Sometimes, a cold or [allergy](/medical-advice/allergies/) can develop into an inflammation of your sinuses called [sinusitis](/medical-advice/ent/acute-sinusitis/). This is usually accompanied by pain in your face, a loss of smell, and green or yellow mucus. 

Occasionally, a chronically blocked nose is caused by the shape of your nose. This can be genetic or caused by an injury.

## How long does a blocked nose last?

The cause of your stuffy nose affects how long your symptoms last.

![Screen Shot 2022-02-09 at 13.16.59](//images.ctfassets.net/h8qzhh7m9m8u/5zZuIJE4LAYAaz60Yv6hiU/86e2a7b1a8ea541b0869429c7438fd97/Screen_Shot_2022-02-09_at_13.16.59.png)

‘Generally, a blocked nose from a virus doesn’t last that long. If it sticks around for more than 10 days, there may be something else going on,’ says Dr Ramskill.

‘If you’re worried or bothered by your symptoms, speak to a doctor or pharmacist. In the meantime, there are things you can do at home for relief.’

## How can I get rid of a blocked nose?

Here are 8 doctor’s tips on how to get rid of a blocked nose.

### 1. Be gentle when you blow your nose
‘When you feel like there’s a blockage in your nose, the temptation is to reach for the tissues and try to clear it quickly,’ Dr Ramskill says, ‘But blowing too hard or too often could cause bleeding or an infection in the sinuses, which will only make things worse.’ Blowing your nose too much can also contribute to the swelling that may be making your nose feel blocked in the first place.

The best way to clear any mucus is to blow your nose gently one nostril at a time.

### 2. Aim to drink 6-8 glasses of water a day 
Staying hydrated can thin out mucus and will also [help your body to fight an infection](/your-health/how-to-boost-your-immune-system-to-fight-off-winter-viruses/) if there is one.

‘Some people might need to drink more or less than the recommended amount, but the important thing is to make sure you don’t feel thirsty,’ says Dr Ramskill.

### 3. Hold a warm flannel to your cheeks
‘Holding a warm compress to your cheeks and face can ease the pressure in your sinuses,’ explains Dr Ramskill. ‘You can do this as often as you need.’

You can make a warm compress at home by soaking a flannel or cloth in warm water and ringing it out. The water should be hot but not scalding, like a bath.

### 4. Dial-up the humidity
‘If you've got a sore, crusty nose, really dry air will make it worse,’ says Dr Ramskill. ‘Making the room more humid can be helpful, especially at night.’

The easiest way to do this is to use a humidifier, but you can add moisture to the air by boiling some water in a pan for 10 minutes or running a hot shower.

### 5. Try a nasal rinse with warm salty water
‘Nasal douching is helpful if you have thick mucus or allergies,’ says Dr Ramskill. ‘Doing this around 5 times a day helps clear the sinuses and soothe inflammation.’

You can make your own nasal rinse with salty water, or buy a saline rinse from a pharmacist or get a prescription from a doctor.

### 6. Use menthol ointment or oil
‘Essential oils like menthol don’t unblock the nose, but the cooling sensation helps you feel like you’re breathing more easily,’ explains Dr Ramskill.

You can dissolve a few drops of menthol, eucalyptus or camphor oil in a bath or a humidifier, or try a plug-in vapouriser. Another option is a vapour rub, which is an ointment you apply to your chest.

### 7. Ask a pharmacist about treatment options
‘If your blocked nose is really annoying or stubborn, there are over-the-counter treatments. Although these are readily available, speak to a pharmacist first to decide which one is best for you,’ says Dr Ramskill. 

The following treatments are available as nasal sprays or tablets:

__Decongestants__
These are for short-term relief only, and usually help colds.

__Steroids__
These are most helpful for allergies or relieving an ongoing blocked nose.

__Antihistamines__
These can help ease allergy symptoms but some can cause drowsiness.

‘It’s best to try decongestants first, but they can actually make things worse if you use them for more than a week,’ says Dr Ramskill. ‘Steroid sprays are the next option and are fine for long-term use.’

### 8. Speak to a doctor if symptoms don’t improve after 10 days
‘A doctor will talk to you about your symptoms to rule out an underlying condition,’ says Dr Ramskill. ‘Depending on what they find, they might issue a prescription or refer you to an ear, nose and throat specialist or an allergy specialist.’

## What helps a blocked nose at night?

Blocked noses often get worse at night and can make it hard to sleep. Try the following remedies before bed:

- Try drinking hot lemon and honey, or ginger tea
- Rinse your nose 
- Take ibuprofen or paracetamol
- Apply vapour rub or use a plug-in vapouriser 

‘Raising your head on a pillow throughout the night will help any mucus to drain away and make it easier to breathe,’ says Dr Ramskill.

## What can help a child or baby with a blocked nose?

‘Children and babies can really suffer with blocked noses, as their nostrils are so much smaller than ours,’ Dr Ramskill explains. ‘Apart from giving them ibuprofen or paracetamol, all the tips for sleeping can also be used for children.’ 

For babies, rather than raise their head on a pillow, you can try raising the cot at one end. ‘Put vapour rub on a baby’s feet rather than their chests, so it doesn’t become overpowering. Babies can’t blow their noses, but you can get a device that gently sucks out the mucus for them.’

## When should I see a doctor about my blocked nose?

If you’re worried about your symptoms, suspect [you might have Covid-19](/your-health/cold-or-covid/) or your blocked nose has lasted more than 10 days, speak to a doctor.

Although a stuffy nose is usually nothing serious, there are some signs to look out for:

- Your nose is only blocked on one side (and always the same side)
- You have a bleeding or crusting nose that keeps coming back
- Watery liquid is dripping from your nose
- Your eyes look swollen or feel painful
- Your sight is affected

‘Very rarely, a blocked nose can be due to a rare form of cancer or a recent [injury to the head](/your-health/treating-concussionwhat-to-do-if-someone-is-showing-symptoms/) or spine. It’s better to catch these things early, so speak to a doctor straight away if you’re worried,’ Dr Ramskill says. 

__This article has been medically reviewed by Kry GP Dr Nikki Ramskill.__


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kry.co.uk > Article page > How to get rid of a blocked nose

How to get rid of a blocked nose – a doctor’s best tips

A blocked nose is one of the most common symptoms of a cold or allergies. Dr Ramskill shares her advice on how to breathe and sleep easier with a stuffy nose.

kry.co.uk > Article page > Meta information > How to get rid of a blocked nose

How to get rid of a blocked nose | Kry

[Irritable bowel syndrome (IBS)](/medical-advice/digestive-problems/irritable-bowel-syndrome-ibs/ "/medical-advice/digestive-problems/irritable-bowel-syndrome-ibs/") is a digestive disorder that [affects about 20% of people ](https://www.mp.pl/paim/issue/article/16067/)around the world.  It’s the [most common gastrointestinal diagnosis](https://www.uptodate.com/contents/irritable-bowel-syndrome-beyond-the-basics) and the second most common cause of absence from work. 

‘IBS is a chronic condition that you’ll need to manage long term,’ says Dr Roshaan Saloojee, a Kry GP. ‘Although it doesn’t lead to severe disease, it can have a big impact on your everyday life, so finding ways to manage it is key.’

While the cause of IBS remains unclear, it’s widely accepted that there is a strong link between gut health and mental health, as a result of what’s known as the gut-brain axis. By learning to manage your anxiety and stress levels, you may be able to minimise your IBS symptoms too.

## What causes IBS, and who is likely to have it?

‘The exact cause of IBS is unknown, but possible causes include over-sensitive nerves in the gut or immune system, food passing through the gut too quickly or too slowly, stress, or a family history of IBS,’ explains Dr Saloojee. 

‘Post-infectious IBS is caused by a previous bacterial infection in the gut, which can then lead to the syndrome.’

You’re more likely to have IBS if:

- You’re under 50 years of age
- You’re female
- You have a family history of IBS 
- You have a history of anxiety, depression or other mental health problems

## What are the most common IBS symptoms?

Common IBS symptoms include:

- Cramping
- Abdominal pain
- Bloating
- Gas
- Diarrhoea and/or constipation

‘Symptoms tend to come and go,’ says Dr Saloojee. ‘They can last days, weeks or months and can vary in severity.’ 

## What’s the connection between our gut and our mind?

The link between the brain and the gut is strong, and virtually every gut function is [sensitive to stress](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791014/).  Most of us are familiar with the gut’s reactions to different emotional and psychological experiences – think about the expression ‘butterflies in the stomach.’

This is because of the gut-brain axis. ‘The brain and nerves that control your body are called the central nervous system, which is divided into 2 parts: the sympathetic and the parasympathetic nervous systems. Some say there’s a third part called the enteric system, which controls the gut,’ Dr Saloojee explains. 

‘The gut-brain axis is a term used to describe the two-way communication between the central and enteric nervous systems, linking the emotional centres of the brain with the functioning of the gut.’

Because of the gut-brain axis, [emotions can impact the gut](https://www.mp.pl/paim/issue/article/16067/) in a number of ways, and the gut can influence your mental state too. 

That’s not to say that all gut symptoms linked to mental health are due to IBS. [Anxiety](/medical-advice/mental-health/anxiety/), for instance, is known to cause everything from stomach aches to a change in bowel movements. 

## Can stress and anxiety cause stomach pain and IBS? 

‘If you have IBS, the balance between the brain and the gut is disturbed,’ says Dr Saloojee. ‘Stress and anxiety can activate the central nervous system, which in turn releases hormones that affect digestive processes in your gut and may cause diarrhoea, constipation, gas or discomfort.’

__The link between the brain and the gut is thought to play a key role in IBS__

![The link between the brain and the gut is thought to play a key role in IBS](//images.ctfassets.net/h8qzhh7m9m8u/4ie1xT8jZYpcCprkuvMbXc/979d02bcb42fdcabb8ed2ebe43e88c3f/IBS_2160x2000.png)

Increasingly, IBS is becoming known as a condition of both irritable bowel and [irritable brain](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4202343/).  In addition to stress and anxiety triggering IBS symptoms, IBS can trigger stress and anxiety, causing a vicious cycle.  A survey of IBS patients found that [44% also suffered from anxiety](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733421/), with 84% suffering from depression.  

‘While the link between stress and IBS is clear, stress is usually not the only influence,’ says Dr Saloojee. But it can play a central role. ‘Stress releases hormones that can negatively impact the gut,’ she says. ‘Chronic stress can cause an imbalance of the gut’s bacteria and be a key factor in a person developing IBS.’

Stress and major life traumas are known to worsen IBS symptoms. Many people experience spikes in their stress levels just before they start getting IBS symptoms.  In fact, some researchers argue that it’s nearly impossible to improve IBS without first addressing stress.  ‘This is why treating IBS in a holistic way is so important,’ says Dr Saloojee.

## How is IBS treated in the context of anxiety and stress?

‘Some people can control their IBS symptoms by managing diet, lifestyle and stress,’ says Dr Saloojee. But when simple lifestyle changes aren’t enough, a combination of medication and counselling can help. 

‘The psychological treatments for IBS with the strongest evidence are CBT, hypnosis and mindfulness,’ adds Dr Saloojee. ‘CBT teaches you to change unhelpful thinking patterns, engage in relaxation techniques and change behaviours that may contribute to physical and mental illness. Patients learn how the stress response is linked to gut symptoms and how to modify these responses. Research shows that [CBT can be effective in improving bowel symptoms](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8630837/), quality of life and reducing stress and anxiety.’

Some researchers believe that IBS patients suffer from[ heightened gut sensitivity](https://www.uptodate.com/contents/irritable-bowel-syndrome-beyond-the-basics) that makes normal gas and bowel movement more painful. That might be why some people with IBS find medicines like antidepressants helpful, as they not only improve mood but may also help[ reduce hypersensitivity in the gut](https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31548-8/fulltext) and pain perception.

## How can I manage stress to prevent another IBS flare-up?

Dr Saloojee recommends identifying the key stressors in your life. ‘It may be helpful to keep a diary of your gut symptoms every day and see if there’s a connection between how you’re feeling mentally and a flare-up of IBS symptoms,’ she says.

‘Once you’ve identified your triggers, you can take steps towards trying to eliminate or manage them. Because of the link between the brain and gut, this may lead to an improvement in IBS symptoms or fewer flare-ups.’

Dr Saloojee’s tips for reducing symptoms are:

- Try stress-reducing activities, like yoga, meditation, [breathing exercises](/your-health/3-breathing-exercises-a-psychologist-recommends/) and regular exercise
- Practise good sleep hygiene by going to bed at a regular time, reducing screen time before bed and keeping your room dark
- Get at least 7-8 hours of sleep per night
- Drink at least 8 glasses of water a day
- Cut down on caffeine, which stimulates the gut
- Eat smaller meals
- Avoid fried or fatty foods
- Avoid foods that are known triggers for you – this might include dairy, beans, lentils, cabbage, broccoli or other gas-producing foods
- Try probiotics (good bacteria), which may relieve gas and bloating
- Try increasing fibre in your diet
- Join an IBS support group
- Take symptom-relieving medication if you need it
- Talk to a GP for further support

## When should I speak to a doctor about stress and IBS symptoms?

‘If you have IBS symptoms and they’re interfering with your daily life, you should see a doctor,’ says Dr Saloojee. 

‘They will take a history of your symptoms and examine you, and they may arrange some blood tests or a stool test. There isn’t a specific test to diagnose IBS, but these investigations can rule out other bowel problems like inflammatory bowel disease, bowel infections, [coeliac disease](/medical-advice/digestive-problems/coeliac-disease/) and bowel cancer.’

There are some symptoms you should never ignore:

- Unintentional weight loss
- Bleeding from your bottom or bloody diarrhoea
- A hard lump or swelling in your stomach
- Shortness of breath, palpitations and pale skin (signs of anaemia)

If you’re experiencing any of these symptoms, they could be a sign of something more serious, so you should see a doctor urgently.

If you’re struggling with stress, anxiety or IBS symptoms, try [talking to your friends and family](/your-health/how-to-talk-about-your-mental-health-if-youre-struggling/), and see a doctor who can help and refer you for further support.

__This article has been medically approved by Dr Roshaan Saloojee, a Kry GP.__


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See a GP about stress and IBS

Kry.co.uk > Your health > How do stress and anxiety affect IBS?

How do stress and anxiety affect IBS?

How do stress and anxiety affect IBS symptoms? Read our doctor’s guide to the gut-brain axis, IBS and anxiety symptoms, and why reducing stress is so important

The link between stress, anxiety and IBS symptoms | Kry 

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