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

kry.co.uk > Your health > Metainfo

Your health | KRY

## Quick facts
- Stress depletes your self-control, so managing it is key
- Setting short and long-term rewards as you complete the steps toward your goal can help maintain motivation
- Willpower can be built up like a muscle, say researchers 

Life is uncertain at the best of times. But right now, there’s little certainty about anything. We can’t plan our lives like we used to, so it’s perfectly understandable if you’re feeling lost and unmotivated. 

Yet, while this next year may be extra challenging in the wake of Covid-19, especially if you’re looking to motivate yourself to reach new wellness, health or personal goals, it’s important not to lose sight of your hopes and dreams. 

That’s why we’re bringing you some of the science on motivation, with easy ways to work it into your 2021 plans. 

Take it slow and work only what you can into your routine — after the year that’s just passed, being easy on yourself is most important.  

## What influences motivation? 

Motivation is the reason behind why we do things. It’s the energising behaviour we adopt in pursuit of a goal.  

Your environment, how you were brought up and your experiences all play a part in what motivates you.   

But there are also two main types of motivation — knowing the difference between the two can help you reach your goals.  

Extrinsic motivation comes from external factors, like a reward or punishment. For example, when you’re driven to complete a work project, because you want to get paid, or because you don’t want to attract criticism, lose out on an opportunity or feel like you’ve failed. 

Intrinsic motivation on the other hand, comes from internal factors. It’s about doing something for the sheer satisfaction or enjoyment it brings you. This is not contingent on any external pressure or reward. 

If you’re looking to get motivated to make some health and wellness, or personal goals in the new year, here are 5 ways to do it based on scientific research. 

## Motivating secret #1 — Learn to manage your stress

Stress may induce changes in your brain that can lower motivation. In a recent study  it was shown that increasing stress levels can affect prefrontal cortical activity (this is the area of the brain that governs the integration of emotion, motivation and cognition) and decrease the motivation to pursue reward.  

In fact, learning to manage stress is one of the most important things you can do to improve your motivation and willpower, say researchers into these areas. 

Being under stress puts you into the fight or flight response and encourages you to focus on short term goals and outcomes. But self-control requires you to keep the big picture in mind. 

So, if you want to stay motivated, incorporate tools to help manage stress into your daily routine. Even if it’s just going for a daily walk, [spending time in nature](https://www.livi.co.uk/your-health/5-health-benefits-of-being-in-nature/), doing some yoga stretches, breathing exercises or doing a daily 10-minute meditation. 

## Motivating secret #2 — Prioritise sleep — especially if you want to maintain a healthy weight 

If one of your goals is to get food cravings under control or to [maintain a healthy weight](https://www.livi.co.uk/your-health/5-simple-tips-for-a-healthy-bmi/), not sleeping enough could sabotage your motivation. 

A recent study  shows that a reduction in sleep of 33% led to increased hunger and food cravings the next day in study participants. The researchers suggested that sleep deprivation activates food-related reward regions in the brain, leading to more hunger. 

In another study  it was found that not sleeping enough could suppress activity in the dorsolateral prefrontal cortex (this is the part of the brain to do with self-control). 

Lack of sleep can also cause an increase in the production of the hunger hormone ghrelin and a decrease in the appetite-suppressing hormone, leptin.  

Read more about simple [lifestyle changes to help you sleep](https://www.livi.co.uk/your-health/4-ways-to-sleep-better-during-the-pandemic/).

## Motivating secret #3 — Connect with your intrinsic motivation

Intrinsic motivation is when you’re motivated to do something you enjoy. When you’re intrinsically motivated you engage in an activity because you find it interesting and inherently satisfying.   

Here are some ways to increase your intrinsic motivation:
- Workout to your favourite music. That way it won’t feel like such hard work
- Listen to your heart and choose goals that resonate with what you love doing. Journaling can help you figure this out. If you’re not sure, think back to when you were small. Was there something you loved to do that you gave up as you got older?
- Do sports you enjoy, not only those you think you should be doing. Then, set goals around them. For example, if you love running, set a goal to complete a virtual 10km by Easter 
- Make a list of activities you love, then figure out ways of working them into your goals. For example, if you love cooking but also want to get healthy, set up an online cooking group with friends you know already have a healthy lifestyle and steal their recipes

## Motivating secret #4 — Create a reward system

Staying motivated is always much easier in the initial stages than it is a few months down the line. One way to keep up the momentum beyond January is to plan a reward system you can use over time, as you move closer to achieving your goals.

For example, if you aim to exercise three times a week, make a plan for what specific exercise you will be doing and how you’ll be doing it. Then, every fortnight that you have managed your goal, reward yourself with a massage. Once you have continued for three months, reward yourself with a new pair of sunglasses (just in time for summer).

Rewards are important in the short-term too though. If your goal is going for a walk five times a week or completing a work project, planning in immediate rewards after you have completed each step toward that goal (for example, after each walk or when you complete a presentation) will motivate you. 

In fact, a recent study  found that immediate rewards you give yourself (especially in the first stages of changing your behaviour while it’s becoming a habit) can boost intrinsic motivation more than delayed rewards. In the study, when people were asked to complete a task, there was a 20% increase in motivation amongst those participants who received an immediate bonus compared to those who received nothing.

## Motivating secret #5 — Build up your willpower muscle

Willpower is the ability to delay gratification and resist temptations to reach a goal.  

When faced with something tempting, the two parts of your prefrontal cortex (remember, that’s the part to do with regulating behaviour) are in competition. 

The right part of the PFC (the dorsolateral prefrontal cortex) is to do with analysing thoughts and self-control and the left (the orbitofrontal cortex) is associated with making decisions based on emotional information.   

But willpower is like a muscle — you can train it to help you make choices that come from the right part, and get you closer to your goals more often. The more you use your willpower, the more your brain will follow healthy cues. 

Here are some simple ways to build up your willpower muscle:
- Reduce stress. If you’re in fight or flight mode, this activates the more primitive, emotional side of your brain so you’re less likely to have self-control
- Break your goals into smaller ones to begin with and add to these gradually. For example, after a month of those daily walks, extend them from 30 to 45 minutes. After another month, switch to an hour
- If you’re trying to improve your diet, don’t keep comfort foods in the house. That way your emotional brain won’t be tempted
- Focus on one or two goals, rather than trying to change your life overnight
- Try the 80/20 approach as this won’t make you feel deprived. 80% of the time, follow through with your goal or healthy choice. For the rest of the time, allow yourself a little leeway
- Spin your goals into something positive. For example, instead of thinking ‘I can’t have chocolate’, focus on how much more energised and alive you feel after eating something healthy

Remember though, to take small steps. Don’t put any more undue pressure on your mind and body than feels right. Now in particular is a time for [self-compassion](https://www.livi.co.uk/your-health/what-is-self-compassion-and-why-does-it-matter/), not just goal-setting.


Livi.co.uk > Your health > 5 motivation secrets to use all year (backed by science)

5 motivation secrets to use all year (backed by science)

If pandemic stress has left you feeling unmotivated, you may need good advice to make your health goals stick. Here’s the science on how to stay motivated

Kry.co.uk > Your health > 5 motivation secrets to use all year (backed by science)

General health

General health and seasonal

## Quick facts
- Indigestion and heartburn are widespread — 40% of adults experience it
- Spicy, fatty foods as well as coffee and alcohol are common triggers
- Being overweight and obese, as well as smoking and stress, are also key causes

Most people suffer from indigestion occasionally and some are more prone to it than others.  

Indulging in rich food and alcohol can overload our digestive systems and leave us with uncomfortable feelings – like heartburn and gas – after eating.

Here we answer your questions, with advice from Dr Rhianna McClymont, Lead GP, Kry.

## What’s the difference between heartburn, acid reflux and indigestion? 

Indigestion can be felt as discomfort or pain in the upper abdomen, also known as dyspepsia. It’s incredibly common with around 40% of adults experiencing it each year. 

One of the main symptoms of indigestion is heartburn and acid reflux (these are the same thing, by the way).  Heartburn is felt as a burning sensation behind your breastbone or in your throat. It happens when acid from your stomach comes up your oesophagus and into your throat, which is called acid reflux. Most people only have occasional episodes, but when this keeps happening, it’s called gastro-oesophageal reflux disease (GORD). 

Dyspepsia and heartburn may occur together or on their own and symptoms usually appear soon after eating or drinking.  

## What causes indigestion?

As well as heartburn, belching or flatulence, bringing food back up from your stomach into your throat, nausea, and feeling uncomfortably full are also symptoms of indigestion. They’re caused by stomach acid irritating the protective lining of the digestive system. 

Indigestion can also be due to the lining in your digestive system being overly sensitive to stomach acid, or it may be stretched  as a result of eating too much.

‘Heartburn is most commonly caused by a laxity in the lower oesophageal sphincter,’ says Dr Rhianna McClymont. This sphincter forms a tight ring between the top of the stomach and bottom of the oesophagus (the food pipe). It opens to let food pass from the oesophagus and into the stomach, and then closes again to prevent stomach acid and food travelling the wrong way back into the oesophagus. ‘With acid reflux, this sphincter is more relaxed than it should be, allowing acid to pass out of the stomach and cause painful symptoms,’ Dr McClymont explains.

## What triggers heartburn and indigestion?

Coffee and alcohol, as well as spicy and fatty foods — including chocolate and tomatoes, according to the NHS  — can be common triggers for indigestion. 

If you’re overweight or obese, you may be more likely to suffer with indigestion. 

Some medicines, like anti-inflammatory painkillers, can cause it too. ‘Medications like ibuprofen are a particularly common trigger for heartburn, so make sure you’re not taking these regularly, unless you have been directed to by your own GP,’ says Dr McClymont.

Stress can also make indigestion worse  — as can smoking. 

Indigestion is particularly common in pregnant women, usually from 27 weeks onwards, with up to 45% of pregnant women suffering from it at some point.  This can be caused by hormonal changes and the growing baby pressing against the stomach.  

## How can I prevent indigestion? 

There are many things you can do to prevent an episode of indigestion. Start by avoiding foods that you know trigger episodes. Cutting back on alcohol and stopping smoking can also help.

If you’re overweight or obese, research suggests that losing weight can be helpful in alleviating symptoms.  

Try to avoid overeating by opting for smaller, more frequent meals. If you can, make your evening meal 3-4 hours before bedtime, as lying down can cause symptoms.

In fact, if you find that you suffer from indigestion mostly when you’re lying down in bed, try raising the top of your bed by 10-20cm with some pillows. Ideally, your chest and head should be above the level of your waist so your stomach acid doesn’t travel up towards your throat. Avoid tight clothes that put pressure on your stomach area too. 

If stress triggers your indigestion, a course of Cognitive Behavioural Therapy (CBT) can help you better deal with pressures and stressors in your life.

## What’s the best over-the-counter medicine?

‘Different preparations work better for different individuals,’ says Dr McClymont. Pharmacies will usually stock a range of over-the-counter medicines such as antacids and proton pump inhibitor (PPI) drugs as well as H2 blockers, she explains. 

‘For mild, occasional, heartburn symptoms, an antacid is generally all that’s needed,’ says Dr McClymont. ‘There are numerous brands available and a pharmacist would be able to talk you through the different options.’

Antacids work by neutralising the acid made by your stomach. Widely available from pharmacies, they’re the medication that most people turn to when they first start suffering from heartburn or indigestion — and most people don’t develop any side-effects.

H2 blockers reduce the amount of acid your stomach makes and are usually taken as tablets, soluble tablets or a drink, with or without food.

PPIs work on the cells that line the stomach to reduce the acid your stomach makes.  However, if you need to use a PPI for more than 4 weeks you should talk to your doctor. 

## I always seem to have indigestion after eating, what should I do?

‘If you have constant indigestion that hasn’t improved with lifestyle changes, talk to a doctor,’ says Dr McClymont. ‘They can discuss your individual symptoms, lifestyle and medication history, and make a plan on whether you need further treatment or investigations.’ A Kry doctor can help take you through this.

## What are the signs I need to see a doctor?

‘If you’ve tried to treat indigestion yourself with lifestyle adaptations or over-the-counter medications and are still experiencing symptoms, then it is best to see your doctor,’ says Dr McClymont. 

Talk to a doctor or Kry GP if your indigestion persists, or you experience any of the following alongside it:
- Severe pain
- Sudden weight loss without meaning to
- You’re 55 or older
- Have difficulty swallowing
- Keep being sick
- Have iron deficiency anaemia
- Feel like you have a lump in your stomach
- Have blood vomit or poo

## Could indigestion be a sign of something more serious?

‘Indigestion is common and will usually resolve quickly with lifestyle changes or over-the-counter medications,’ says Dr McClymont. 

‘Occasionally, it can be something more serious. If you’re worried, your indigestion has become persistent or it’s occurring with other symptoms then you should speak to a GP.’

Rarely, it’s a sign of something more serious for example, hiatus hernia, an infection, stomach ulcer or in rare cases, cancer. There’s probably no reason to worry, but it’s always worth discussing with a doctor if your indigestion is persistent and unresponsive to lifestyle changes. 

## How Kry can help

If lifestyle changes and medication don’t help, your doctor may refer you for an endoscopy, for further investigation. An endoscope is a long, thin, flexible tube that has a light and camera at one end so images of the inside of your body can be seen on a screen. It’s not usually painful but may be a little uncomfortable and usually takes 15-45 minutes.  This procedure can help a specialist determine any deeper causes of your indigestion and identify a course of suitable treatment.

__This article has been medically approved by Dr Rhianna McClymont, Kry Lead GP__


Kry.co.uk > Your health > Heartburn and indigestion — your questions answered

Heartburn and indigestion — your questions answered

It’s the season for eating, and that can come with feelings of a burning in the chest, gas and other signs of heartburn and indigestion. A GP gives her tips

Since the start of the coronavirus, with its limitations on mixing and face-to-face contact, naturally, more people report feeling lonelier and disconnected from one another.

But even before the pandemic, loneliness was a global issue affecting millions of people.

Around nine million people in the UK said they felt lonely, in a report by The Campaign to End Loneliness.

Now as the uncertainty of the current times continues, compounded by the darker days of winter, many people are facing more emotionally challenging times, including deeper loneliness and isolation. 

‘During difficult times, it’s natural to want to pull together and support each other’, says Madeleine Gauffin, Licensed Psychologist and Licensed Psychotherapist at Kry. 

There are lots of situations where most people would turn to friends and family for support, like after job loss or bereavement, Gauffin points out. ‘But current social restrictions are forcing people to fall back more on their own resources and not everyone is equipped for this. 

‘If you’re feeling lonely and isolated, it can be easy to get things out of proportion, so fears and anxieties get even bigger,’ says Gauffin.

‘Most people feel lonely at times, but there are also certain life stages when you may be more likely to feel lonely, like after a divorce or moving to a new area,’ says Gauffin. 

## Loneliness and solitude — the key difference

For some people, not having to deal with social situations can be a relief. ‘Feeling lonely is not the same as being alone,’ says Gauffin. ‘You can be alone and feel perfectly content in solitude.’ 

Loneliness is the feeling that your needs for social connection aren’t being met. And it can happen not only to those who feel the lack of other people in their lives, but also to some people in relationships and communities where they don’t feel accepted and supported.

Research shows that social isolation and loneliness increase the risk of developing a variety of physical and mental health conditions. These include high blood pressure, heart disease, obesity, anxiety, depression, cognitive decline, addiction and a weakened immune system. 

Here are some expert recommendations for dealing with increased loneliness during a more restricted festive season this year.

### 1.  Meet up online

‘While there are some people who never want to attend another Zoom meeting again, if you can’t see friends or family in real life, it helps to make the effort to keep in touch with people in any way you can,’ says Gauffin.  

Making a list of the people in your life can also help you to see more opportunities to connect with others, Gauffin suggests. 

‘You can consider starting new networks, too, like an online book club. Or, arrange to have dinner with friends or family over the internet.’  

### 2.  Keep walking

A recent study has shown that even going for a walk on your own for at least 20 minutes a day can help to reduce feelings of loneliness. ‘When you’re outdoors, your world opens up,’ says Gauffin. 

‘You see nature and other people, and this is a good distraction away from your own thoughts. If you can’t see people indoors, going for a walk or a hike with a friend is a good way to connect.’ Find out more about [the benefits of walking.](/your-health/the-power-of-walking-for-your-health/)

### 3.  Maintain a healthy daily routine

Create a daily routine,’ says Gauffin. ‘Get up at the same time, have breakfast, do some work, have lunch, go for a walk and schedule in meetings and phone calls. 

‘This will stop you from falling out of sync with your natural circadian rhythms. If you’ve got things to do and look forward to, it will help you to feel less lonely.’

### 4.  Focus on things that make you feel better 

‘Ask yourself — “What do I need right now? What do I need to take care of myself better?”’ says Gauffin. 

‘Even if you’re on your own, there’s no reason why you can’t prepare a lovely meal for yourself, or do an hour of yoga or meditation. Remind yourself that you’re not the only one feeling lonely.’

### 5.  Get professional help

If you’re stressed, anxious or you’ve had a low mood for longer than 2 weeks, or nothing you do seems to be helping, a Kry GP can help.

‘Your doctor can refer you to a psychologist or psychotherapist,’ says Gauffin. ‘It could be that lockdown is bringing up issues related to experiences in your past. Also, don’t hesitate to call a helpline if you feel lonely.’

To contact the Samaritans, visit: [www.samaritans.org](https://www.samaritans.org) or call 116 123.

__This article has been approved by Madeleine Gauffin, Licensed Psychologist and Licensed Psychotherapist at Kry.__


Kry.co.uk > Your health > 5 ways to cope with loneliness this winter

5 ways to cope with loneliness this winter

It’s normal to be feeling lonely as the dark days of winter set in. Here are some healthy ways to cope

### Quick facts
- Prostate cancer is the second most common cancer in men
- Most cases are diagnosed in men over 50
- It might not show symptoms, and may require little or no treatment

It’s that time of year again, when men grow moustaches — ranging from flattering to funny — in support of Movember. 

The campaign raises awareness and funds in three areas: [male suicide](/your-health/signs-of-depression-in-men/) — which claims 60 men every hour globally — as well as [testicular cancer](/your-health/testicular-cancer-how-to-spot-the-signs/) and prostate cancer. 

Here we talk to Dr Rhianna McClymont, a Kry GP, about the facts on prostate cancer.

### What is the prostate? 

Around the size of a walnut, the prostate is located just below the bladder and in front of the rectum. It’s a gland only men have.

Its main function is to produce the thick, white fluid that creates semen when mixed with sperm produced by the testicles. 

### Prostate cancer — common among older men

The Movember campaign has made many of us more aware of prostate cancer. Thankfully so, as it’s the second most common cancer in men, and the fourth most common cancer overall.

In fact, more than 1.2 million new cases of prostate cancer were recorded globally in 2018 and in excess of 350,000 deaths. 

The UK is in the top 18 countries with the highest rate of prostate cancer.

### What increases the risk of prostate cancer?

__Age__ – Most prostate cancer cases are diagnosed in men over 50. ‘Age is an important risk factor, with the risk of getting prostate cancer rising as you get older,’ says Dr McClymont. 

__Ethnicity__ – ‘Research has shown that men from an African-Caribbean or African descent are more likely to get prostate cancer’.

__Family history__ – ‘If you have a dad or brother who has developed prostate cancer, particularly if this developed earlier in life before the age of 60, then the risk is higher,’ Dr McClymont says. 

__Obesity__ – According to the NHS, recent research suggests obesity increases the risk of prostate cancer.

### What are the symptoms?

Prostate cancer often shows no symptoms in its early stages and, in fact, may require no or minimal treatment. 

However, as the disease progresses common symptoms can include:
-  Passing urine more frequently (particularly at night)
- Difficulty in starting to pee, or a weak flow of urine
- Feeling like your bladder hasn’t emptied completely 
- Feeling like you need to pee urgently

### How is prostate cancer tested?

‘If you have any of the above symptoms, you may be offered a Prostate-Specific Antigen (PSA) test (taken as a blood test) and an examination of your prostate by your GP,’ says Dr McClymont. The latter will include a rectal exam. 

‘A PSA test can indicate a problem such as prostate cancer, but your PSA level can also be raised for a number of other reasons, so it’s not conclusive,’ she points out. 

‘Usually, an MRI scan will also be used to assess the prostate if a PSA level is raised, and prostate cancer is then diagnosed with a biopsy.’ 

### How is it treated?

Treatment for prostate cancer depends on the severity of the cancer, whether it has spread outside the prostate to other areas of the body, your general medical fitness, and other health conditions you may have. 

‘There are numerous treatment options, including surgery, radiotherapy, hormone therapy or “watchful-waiting”. This is where the cancer is unlikely to affect your natural lifespan, so symptoms are controlled while the cancer is monitored, to make sure it’s not progressing,’ says Dr McClymont. 

‘Any form of treatment involves potential side effects,’ she points out. ‘If surgery to remove the prostate gland is recommended to treat the cancer then these are important considerations. 

‘Following a prostatectomy (removal of the prostate), for example, many men subsequently suffer with difficulties getting or sustaining an erection, and also with urinary incontinence.’

It‘s worth remembering that while prostate cancer may be a serious disease, most men who are diagnosed with it do not actually die from it. 

Watchful waiting has advantages and disadvantages. You won’t have side effects from any treatment or need regular scans or biopsies, and if you begin to suffer from symptoms such as pain or swelling, there is treatment to help manage them. But most men never need treatment. 

Disadvantages can include the possibility of the cancer growing and spreading, and the man and his loved ones having the psychological worry that he’s not being treated.

‘Usually, the watchful waiting approach is for men with mild cancers that are not causing significant problems — and are unlikely to develop them throughout their lifetime. Or for men with other health problems who may not benefit from more invasive treatments like surgery or radiotherapy,’ Dr McClymont points out.

Talk to a doctor if you have any symptoms or concerns.

__This article has been medically approved by Dr Rhianna McClymont, Lead GP at Kry__


kry.co.uk  >    article page >   CTA

See a GP about prostate cancer

Kry.co.uk > Your health > Prostate cancer — a doctor’s guide

Header GettyImages-1181205697

Men are less likely than women to see a GP over worrying symptoms. But here’s why prostate cancer shouldn’t be ignored

Prostate cancer — a doctor’s guide

Men Health

Men's Health

### Quick facts
- Viral infections can cause temporary lactose intolerance
- Anxiety can cause physical symptoms, including tummy pain and bloating
- Constipation is a common cause of stomach aches in children

‘My tummy hurts,’ is something you may hear quite often as a parent. And it’s very normal – as many as 1 in 4 school-age children experience bouts of abdominal pain. But because there are so many potential triggers for tummy aches, it can be hard to identify the cause. 

‘The most important factor is your child’s general appearance; if they look healthy, that’s very reassuring,’ says Kry Paediatric Consultant Dr Tommy Södergren. 

‘Get them to move around: if they can move without pain, that’s also a very calming sign. Try asking if they want their favourite food, if they say ‘”yes” it’s unlikely there’s anything seriously wrong.’

Here are some common causes of stomach pain in children, and what you can do to help.

### Constipation 

Constipation in children often leads to stomach aches, particularly when toddlers are being potty-trained. 

Clues include:
- Poo that’s large and hard, or looks like little pellets or rabbit droppings
- Not having done at least 3 poos in the past week
- Straining to poo
- Bleeding during or after a poo
- Stomach pain easing after a poo
- Soiled underwear; caused by diarrhoea leaking around the hard, constipated poo

Dr Södergren advises: ‘Encourage them to go to the toilet if they can.’ Offer prunes and high-fibre snacks, or ask a doctor about a suitable laxative. 

To prevent problems, make sure they’re getting plenty of fluids and increase their intake of high-fibre fruit, vegetables and pulses.

Make sure your child can rest their feet on the floor or a step when they’re using the toilet or potty – and make it a fun, relaxed time. If they’re anxious about using the toilet away from home, encourage them to go after eating breakfast, and following an after-school snack.

See a doctor if it persists.

### A build-up of gas 

Cramps, and waves of intense abdominal pain can be caused by a build-up of gas. This is common in infants, but can happen throughout childhood too.

Dr Södergren says he’s seen parents take their child to an emergency department — only to find the pain has disappeared because the movement of the car journey has broken up the large bubbles of gas that caused it. 

Encourage your child to walk, or push them in a buggy along bumpy terrain – this will have the same effect.

Gas can build up because a child’s digestive tract is still maturing and is sensitive to upsets. If it happens a lot, keep a food diary to see if particular foods trigger pain in your child. For example, a build-up of gas and flatulence could indicate lactose or gluten intolerance.

### Emotional upsets 

Although emotional upsets can trigger tummy ache, it doesn’t mean the pain is imaginary. Something can feel ‘gut-wrenching’ or prompt ‘butterflies’ in our stomach because of complex chemical and neural signals going back and forth between our brains and our bellies. ‘The stomach is the window to the soul,’ says Dr Södergren. 

Anxiety, stress and other emotional challenges can cause pain, bloating, constipation, diarrhoea and other physical symptoms. Other clues are poor concentration, sleep problems, irritability and being clingy or fidgety. 

The first step is always to talk to your child, and speak to their teacher or childminder to check whether there are any problems away from home.

### Viral infections 

Viral infections are easier to spot as they’re usually accompanied by diarrhoea and/or vomiting. Pain tends to be generalised over a large area, and the gut often makes gurgling sounds. 

Rest and rehydration are generally all that’s needed, and Dr Södergren says parents shouldn’t worry if children don’t eat for a day or two. ‘These infections can cause temporary lactose intolerance, so it’s a good idea to give up milk for a couple of days,’ he adds.

Encourage children to put the toilet seat down when flushing, to minimise aerosol transmission of the virus. And be vigilant with hand washing. 

### Urinary tract infections (UTIs)

UTIs can cause abdominal pain, and in infancy are equally common in boys and girls. This is because the distance between the urethra (the urinary tract opening) and the rectum (the source of bacteria which cause infections) is still short.

Dr Södergren says if your child complains of stinging when they pee, and pee more frequently, then they probably have a UTI. Children with UTIs may also have a temperature, wet themselves, or try to hold their pee.

Most infections clear within 48 hours but if symptoms persist, see a GP. Teach your child to wipe their bottom away from their genitals to reduce the risk.

### When to see a GP

Dr Södergren stresses that most abdominal pain is not serious, and advises, ‘If the pain is not severe, and there are no other symptoms, call your doctor in a couple of days if it doesn’t get any better — but call straight away if it gets worse.’

You can add your child to the [Kry app](/gp-appointments-online/doctor-app/) under your account, so if you need to see a GP for your child’s tummy problems, you can do so by video the same day.

### Red flag symptoms you should not ignore

There are some symptoms you really shouldn’t ignore — get emergency medical help if your child develops any of the following:
- Extreme pain that doesn’t ease with paracetamol or ibuprofen 
- Your child becomes pale and floppy
- Cold hands and feet
- Drowsiness, difficult to wake
- Testicular pain

### 3 causes of stomach pain in children that need urgent care

__1.  Appendicitis__
This is the medical emergency parents often associate with extreme abdominal pain. It’s caused by inflammation of the appendix, which is a pouch, between 5cm and 10cm long, that hangs from the large intestine.

The first sign is usually intermittent pain in the middle of the abdomen, which quickly moves to the lower right-hand side and becomes constant and very severe. 

‘Walking, coughing or pressing the area will make the pain worse,’ Dr Södergren says. Other symptoms include nausea, fever and a change in bowel movements. It needs urgent medical treatment.

__2.  Testicular torsion__
This occurs when a testicle becomes twisted inside the scrotum, cutting off the blood supply. It is most common in teenage boys, but can occur in younger ones. The pain is intense and generally felt in the groin. It requires emergency surgery.

__3.  Poisoning__
Depending on the toxin ingested, poisoning will present in different ways. 

Potential poisons found around the home include household cleaners, medicines, pesticides, some plants and fungi, alcohol and recreational drugs. Faulty boilers can also release toxic carbon monoxide.

Apart from stomach pain, other warning signs include:
- Vomiting
- Confusion
- Drowsiness
- Fainting fits

If you suspect poisoning, don’t try to treat your child yourself. Get urgent medical advice.

__This article has been medically approved by  Dr Tommy Södergren,
Paediatric Consultant at Kry__


Kry.co.uk > Your health > What’s causing your child’s stomach ache?

What’s causing your child’s stomach ache?

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The weeks and months after giving birth can be a vulnerable time for new parents. If you think you may be suffering from postnatal depression, here’s how you can find help.

### Quick facts
- Depression among new mothers has almost tripled since the start of
the pandemic
- Up to a third of new fathers can experience depression, yet only 1 in 5
seeks help
- Support and therapy are available through your doctor

Having a baby can be one of the happiest times. But it can also be stressful — one that can bring feelings of confusion, loneliness and for many, depression.

‘Adjusting to motherhood can be a challenge under normal circumstances,’ says Dr Elisabeth Rosen, medical doctor at Kry.

‘But giving birth during a pandemic presents extra concerns — social distancing, changes in hospital procedures and worries about exposure to Covid-19, can make women feel even more susceptible to anxiety and depression.’

### You’re not alone

Postnatal depression is a common problem that affects 1 in 10 women in the UK, within a year of giving birth.

A new study shows that depression among expectant and new mothers has almost tripled since the start of the coronavirus pandemic – going from 15% to 41% of new mothers. It also showed moderate to high anxiety rose from 29% to 72% in pregnant women and new mothers.

### Postnatal depression or ‘baby blues’?

‘It‘s perfectly normal for many women to experience what‘s commonly known as the ‘baby blues‘ in the first week or so after giving birth,‘ says Linda Karlsson, Licensed Psychologist at Kry.

‘This can last anything from a few days to a week or so.‘ Typical symptoms include feeling emotional and bursting into tears for no apparent reason, feeling irritable or touchy, low mood, anxiety and restlessness.

‘If you’re still feeling low after 2 weeks, this may be a sign of postnatal depression. This can also affect fathers and partners.’

### Symptoms of postnatal depression

Postnatal depression can occur at any time in the first year after giving birth. ‘All women are different and not all women with postnatal depression get all the symptoms,’ says Karlsson. If you get any of the symptoms below, talk to a doctor or psychologist.

__Main symptoms include:__
- Persistent depression, sadness and low mood
- Lack of energy and feeling tired all the time
- Lack of enjoyment and interest in the wider world

__Other symptoms may also include:__
- Problems sleeping at night and feeling sleepy during the day
- Difficulty bonding with your baby
- Withdrawing from other people
- Lack of concentration and finding it hard to make decisions
- Disturbing thoughts, for example, about hurting your baby or suicide

### How your hormones can affect your mood after childbirth

‘We don’t know exactly why postnatal depression occurs,’ says Dr Rosen.
‘But one of the reasons (although there’s no conclusive evidence for this) may be the rapid drop in the hormones oestrogen and progesterone straight after you give birth.’

‘Low progesterone can cause anxiety, mood swings, irritability and depression,’ says Dr Rosen.

‘The drop in oestrogen can also trigger depression and anxiety. While the
increase in the calming, bonding hormone oxytocin (that [occurs during breastfeeding](/your-health/breastfeeding-whats-happening-in-your-body/)) should help to compensate for this, it seems that in some women this doesn’t happen. Once you stop breastfeeding, hormones should gradually go back to normal.’

Be aware, though, that postnatal depression can be triggered by many other factors, and it differs from person to person.

### Breastfeeding and emotions

Some women who are breastfeeding experience abrupt dysphoria, or negative emotions like sadness, depression, anxiety and irritability just prior to the moment milk is released. This is a condition called Dysphoric Milk Ejection Reflex (D-MER).

These feelings are usually brief and pass in 30-90 seconds. While they can be distressing, it can be reassuring to know that these are not a sign of postnatal depression.

But if you‘re experiencing postnatal depression, D-MER will be harder to handle.

So it’s important to get help from a doctor or a psychologist.

### Who’s at risk of postnatal depression?

Some people will be more at risk of developing postnatal depression — these include:
- Women (and men) with a history of mental health issues, particularly
depression
- A history of mental health problems during pregnancy
- Having no close family or friends to support you
- A poor, troubled or abusive relationship with your partner
- A history of substance abuse
- Lack of sleep after the baby is born
- A stressful or traumatic labour
- Feeling overwhelmed and worried about being a parent
- Having experienced recent stressful events like a bereavement or
separation from your partner
- Experiencing the baby blues
- Financial worries

### Postnatal depression in men

It’s not just women who are at risk of developing postnatal depression – men can get it too.

Until recently, it was believed approximately 10% of new fathers experience postnatal depression. But a recent study suggests this figure might be as high as 27%. Yet fewer than 1 in 5 fathers who were depressed sought help, and a third had considered self-harm.

The study showed that while many women are screened for postnatal depression, the mental health of fathers is rarely assessed. What’s more, postnatal depression in men may show itself in different ways, like anger, irritability, working longer hours and drinking too much.

Read more about the signs of [depression in men](/your-health/signs-of-depression-in-men/).

### Help for postnatal depression

‘To meet the criteria for postnatal depression, symptoms need to last for at least 2 weeks,’ says Dr Rosen. ‘It usually happens between 4 and 6 weeks after giving birth, but may be any time after pregnancy. ‘There is an expectation of women that they should feel super-happy after having a baby, but many women are hesitant to admit they don’t feel this way.

‘In fact, it’s common for new parents to feel depressed, confused, frustrated, tired and disillusioned — that’s nothing to feel ashamed of.‘Support and treatments are available, so speak to a doctor, who can help you to work out what are the best options for you.’

In the UK, many healthcare visitors have been trained to recognise postnatal depression and can help advise you on strategies that can help.
‘Whatever you do, don’t suffer in silence,’ says Dr Rosen. ‘If you think your partner is having problems, encourage them to get help too.’

### Postnatal depression self-help

__Talk to family and friends__. Tell them how you’re feeling and don’t be afraid to ask for help with things like looking after the baby, so you can catch up on sleep or have a night in with friends.

__Find local support__. If you don’t have anyone to turn to, for example, you’re a single mother with no friends or family close by, look for local support groups. A doctor should be able to help you find one in your area.

__Rest__. Try not to be a perfectionist. It doesn’t matter if your house doesn’t look immaculate, or if not all the chores are done. It’s more important that you catch up on sleep and rest when you can.

__Eat healthily__. Having a baby makes demands on the body. So eating a healthy diet and exercising regularly (or when you can) is crucial. If you haven’t the energy to go shopping or cook properly, ask friends and family to help out until you get back on your feet again.

### Expert help available

__Psychological therapies__. Your doctor can refer you for a course of therapy with a psychologist. Cognitive behavioural therapy (CBT) is shown to be effective in treating postnatal depression.

__Medication__. Antidepressants may be recommended in certain cases where
depression is severe and other treatments haven’t helped. Your doctor will
advise you on the safest options to take if you’re still breastfeeding.

If you have a history of mental health issues or depression, or a family history, talk to a doctor or mental health team if you’re thinking about having a baby.

Your doctor should arrange for you to be seen regularly in the first few weeks after giving birth.

__This article has been approved by Dr Elisabeth Rosen, medical doctor, Kry__


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Kry.co.uk > Your health > Help for postnatal depression

Help for postnatal depression

If you think you may be suffering from postnatal depression, here’s how you can find help

Life events

As the uncertainty in all of our lives continues, it’s understandable to sometimes feel overwhelmed, stressed and anxious. 

But there’s something a growing number of people are turning to that can help — the practice of self-compassion.

At its core, this is simply about treating yourself with the same kindness and compassion that you would show a close friend. And it comes with benefits not only to your emotional wellbeing, but also to your physical health.

### 1.	Self-kindness
Being warm, understanding and kind towards yourself when you’re suffering, feeling inadequate or as though you’ve failed 

### 2.  Common humanity
Recognising that you’re not alone and that suffering is part of the shared human experience

### 3.	Mindfulness
Observing and ‘sitting with’ your feelings as they are (see below), without trying to suppress, judge or deny them

## Do you need to be more self-compassionate?

Here are some signs that it might be good for you:
- You beat yourself up emotionally with negative self-talk
- You find it hard to care for yourself, for example by eating healthily and exercising regularly 
- You have little or no work-life balance
- You suppress and ignore your emotions
- You’re critical and unforgiving of what you perceive to be your faults, mistakes and weaknesses
- You always feel anxious and tense
- You live in the past and the future — not the present
- You drink, overeat, or smoke too much as a way to numb your feelings
- You replay conversations and situations in your head, wishing you’d done things differently
- You’re always comparing yourself to others in a negative way

## What’s the point in being more self-compassionate?

### 1.	It lowers anxiety and stress
Giving and receiving care to others is part of the human survival instinct, that helps us feel safe and connected to family and friends. 

Showing this same care to ourselves also activates this system through self-soothing activities, like touch and kind self-talk. This triggers the release of the love or bonding hormone oxytocin, which can help reduce anxiety, stress and fear. Oxytocin is produced when we touch ourselves and others, hug and have sex. It’s also produced by new mothers when they caress their baby, and also during breastfeeding.

### 2.	It can improve physical health
Oxytocin reduces levels of stress hormones like cortisol and adrenalin. Chronically raised levels of stress hormones can be harmful to the body, contributing to problems with your digestive, reproductive and circulatory systems. 

### 3.	It might support immunity
When stress hormones are elevated for long periods, the immune system can become weakened too. Being kinder to yourself calms the heart rate, toning down the body’s fight-or-flight stress response – helping reduce stress hormone levels.

### 4.	It could help you cope with pain
Research shows that self-compassion helped women cope better with difficulties relating to chronic pain. It also helped them engage more in activities they enjoyed — despite the pain — which helped decrease depressive symptoms.  

### 5.	It might help you reach your goals
Being more accepting and compassionate toward yourself — and less critical — makes you better able to deal with failure. That means you’re more likely to take the calculated risks needed to reach your goals. 

A recent study shows that people who were low in self-compassion were more likely to experience psychological distress when they had a setback. This often caused them to disengage and give up. 

On the other hand, the more self-compassionate people were less likely to show negative emotional reactions. Self-compassion can help you perceive setbacks as a normal part of life. That means you’re more able to regulate your emotions when things don’t go to plan (which is often!)

## How to be more self-compassionate, every day

Self-compassion is a skill that takes practice. These tools can help:

### Use self-soothing phrases
Learn some phrases that resonate with you that you can repeat silently whenever you feel anxious, overwhelmed or distressed. Kristin Neff suggests these:
- May I be kind to myself in this moment
- May I give myself the compassion I need
- May I learn to accept myself as I am
- May I forgive myself
- May I be strong
- May I be patient

### Rate your behaviour, not yourself
This means reframing your inner critic in a friendly, positive way. For example, rather than feeling bad and disgusted with yourself for overeating, instead tell yourself: ‘I know you ate all the chocolate/biscuits, but that’s okay. You’re feeling sad and you thought it would help. But it’s made you feel even worse. Why not go for a long walk so you feel better instead?’  

### Keep a self-compassion journal
Try this for a week or so. Every evening, write down the day’s events that have made you feel bad about yourself. Maybe you were rude to someone or didn’t call a friend when you said you would.  

Rather than berating yourself, write down how you feel — for example, you’re disappointed in yourself. Then think about what led you to behave that way: were you frustrated? Tired? Or feeling overworked? 

Write down some words of kindness and comfort toward yourself. Forgive yourself and accept that you messed up — maybe you can do it differently next time.

### Take a moment to listen to yourself
You might be a good listener for others, but self-compassion is about becoming a good listener for yourself too. Try this whenever you feel anxious, overwhelmed or self-critical:  
- Take a moment to sit quietly and focus on your breathing
- Notice and name your emotional experience — for example ‘I’m feeling anxious’
- Become aware of where you feel it in your body. It may be a tightness in your chest or throat. Emotions are commonly felt somewhere in the body as physical sensations
- Remind yourself that you’re not alone, that everyone feels like this at times and that it’s only a feeling; it will pass. And it can’t hurt you
- Soothe yourself with kind words or gestures — what would you say to or do for a friend feeling like this? 
- Place your hand where you feel the emotion most intensely in your body (this is commonly the heart, throat or abdomen but may be somewhere else for you) and gently breathe. Focus on the warmth of your hand and allow yourself to feel more soothed, accepted and loved. 

__Reviewed By: Dr Rhianna McClymont, Lead GP, Kry__


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Kry.co.uk > Your health > What is self-compassion — and why does it matter?

What is self-compassion — and why does it matter?

Learning to show yourself kindness and compassion can benefit your health — both physically and mentally

Want to know the answer to the question: how much should I weigh? It’s probably not surprising that there’s no one-size-fits-all answer. Calculating your overall health is complicated, but there’s one simple method many people use – and that’s BMI. 

BMI stands for body mass index. It takes your age, height and weight into account, and gives you a score on a chart ranging from underweight to extremely obese. The healthiest weight is somewhere in between. 

BMI has its limitations – like not considering your distribution of fat and muscle – but it’s a good way to understand whether you’re at a generally healthy weight.

## Benefits of a healthy BMI

- Reduced risk of Covid-19 complications
- Reduced risk of type 2 diabetes
- Reduced risk of [cardiovascular disease](https://www.livi.co.uk/medical-advice/cardiovascular-disease/) and [heart attacks](https://www.livi.co.uk/medical-advice/cardiovascular-diseases/heart-attack/)
- Fewer joint and muscle problems
- Improved fertility
- Better mobility and self-confidence

## How to lower your BMI

The best way to lower you BMI is to make simple changes towards a healthier lifestyle. Here are some things you can do to help.

### 1.  Don’t bother with crash diets

Ever put yourself on a serious diet to lose weight quickly before an event? Or tried to keep up with so many diet trends that you flick from one to the next? It happens.

But these ‘quick fix’ diets do not work for the longer term, and are certainly not the best way to lower your BMI. You’re likely to lose weight fast because of the dramatic change, but it’s not sustainable to adapt your eating habits this way indefinitely.

A balanced, calorie-controlled diet is the ticket to a healthy BMI – the safe way. By making simple [healthier food swaps](https://www.livi.co.uk/your-health/8-ways-to-make-healthier-food-choices-every-day/), reducing portion sizes and cutting down on high-calorie food and drink, you’re more likely to reach a healthy BMI steadily, and keep the extra weight off.

### 2.  Look out for hidden sugar

The government recommends that adults should have no more than 30g of sugar a day (roughly equivalent to 7 sugar cubes), children aged 7 to 10 should have no more than 24g of free sugars a day (6 sugar cubes), and children aged 4 to 6 should have no more than 19g of free sugars a day (5 sugar cubes). 

Consuming more than the recommended amount of sugar can be a real hindrance to achieving, or maintaining, a healthy BMI. When trying to lose weight, many of us make the decision to cut down on sweet treats and fizzy drinks – but unfortunately, sugar often creeps into a lot of unexpected foods. Examples include:
- Pasta sauces
- Granola and cereal bars
- Salad dressings
- Tinned fruit in syrup
- Coleslaw
- Ketchup
- Shop-bought soups

If you’re trying to reduce your sugar intake, think about the surprising sources of hidden sugars, as well as the obvious ones, like cake and chocolate. Take your time when doing the food shop and check pre-packages products for their sugar content. 

### 3.  Get your heart pumping

It’s no secret that the more you exercise, the more you can lower your BMI, healthily. NHS recommends doing at least 150 minutes of moderate intensity exercise a week (for example a [brisk walk](https://www.livi.co.uk/your-health/the-power-of-walking-for-your-health/), hiking or cycling), or 75 minutes’ vigorous intensity. You should mix up cardio and strength training to strengthen key muscles and achieve better weight loss results.

Vigorous intensity activities include:
- Running or jogging
- Fast swimming
- Cycling fast or uphill
- Gymnastics
- Using a skipping rope
- Martial arts
- Playing sports like football, rugby and netball

And don’t worry about the cold weather approaching. There are still plenty of [benefits of exercising outside in winter](https://www.livi.co.uk/your-health/5-reasons-to-keep-exercising-outside/) – like better immunity and a boosted metabolism – so you don’t need a gym membership if you don’t want one. 

### 4.  Simply move more

Sometimes it’s hard to find the time for a proper workout – work and family commitments might get in the way. If you’re looking to add more exercise to your daily life, but can’t commit to a strict gym routine, simply get moving throughout the day to burn calories. 

Walk or cycle to work if you can, and choose stairs over the lift. These are not only healthy changes towards a healthier BMI, they’re also very suitable with social distancing guidelines in place.

Using a step tracker on your phone is a good way to see how much you’re really moving day-to-day. If you can’t get to the gym, try to walk 10,000 steps a day, even if just running errands. It can help more than you may think. 

Ready to make the effort to maintain a healthy BMI? Try using the [NHS BMI calculator](https://www.nhs.uk/live-well/healthy-weight/bmi-calculator/) to see where you fall on the scale, and get suggestions for managing your weight. 

### 5.  Get the right support

When working towards a healthy BMI, many people find it easier spending time with others who have the same goal. You could try a group weight loss programme, gym support groups and classes, or even just a social media community with like-minded people.

Even just the right encouragement from friends and family can make a huge difference to your success. If you have a friend in the obese or overweight range, go on a health journey together and check in with each other regularly. If you live with your partner or have a family, cook vibrant, tasty meals with plenty of goodness they’ll enjoy. By making these few simple lifestyle tweaks, you can be well on your way to a healthier BMI.

Want to make your lifestyle changes permanent? Try these tips to help make your new [healthy habits stick](https://www.livi.co.uk/your-health/5-habits-for-living-a-healthier-lifestyle/). 
__Reviewed By: Dr Rhianna McClymont, Lead GP, Livi__

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Livi.co.uk > Your health > 5 simple tips for a healthy BMI

5 simple tips for a healthy BMI

As we become more aware of the risks of obesity, it’s important to keep to a healthy body mass index (BMI). Follow these 5 simple tips for success.

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5 simple tips for a healthy BMI | How to lower your BMI | Kry UK

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