Dealing with the effects of too much festive cheer
While we should all be preparing for a quieter Christmas this year, many of us will still run the risk overindulging in rich food and suffering indegestion or a post-festivity headache. Pharmacist Raj Aggarwal, based in Cardiff, talks about these two common conditions and how they can be effectively treated...
BEFORE we discuss festive ailments, can I first remind readers that we are still in the middle of the flu season as well as a pandemic.
Recognising that we should avoid catching flu while there is a risk of Covid infection, there is now a free flu vaccination available through community pharmacies for all readers over 50 years old.
Stock has been in short supply, however there is stock now available, so please ask your local community pharmacy or surgery for an appointment.
My pharmacy team deals with a large number of requests for advice at this time of year, and one of the main ones is people suffering from headaches.
Many people will from time to time experience a headache, and occasional headaches are nothing to worry about and are quite easily treated.
Research shows that between 80% and 90% of people report that they have experienced a headache during the past year. With so many different products on the market, it is difficult for people to decide which product is most suitable, and that is why I would encourage everyone to seek the advice of their local pharmacist rather than buy the product that they can remember from the latest TV campaign, as these are often not the best product for them and their condition.
Headaches are not always straightforward, as there are a number of different types of headaches and a number of different causes.
Research shows that women are unfortunately more likely to suffer from headaches than men and to have headaches more frequently. Tension headaches and migraine are the primary headaches dealt with in a community pharmacy.
These can both be treated effectively with painkillers obtainable from a pharmacy. Cluster headaches are much less common and are often more difficult to treat.
Tension headaches are the most common headaches and affect up to 80% of the population at some time and it is no surprise that these often increase in the build-up to Christmas, which can be a stressful time for many.
A tension headache feels a lot like pressure or a tight band around the head and headaches of this nature often only last for a few hours. This pain is often associated with stress or tension and the pain sometimes spreads into the neck area.
Migraine is a more severe type of headache. Around 15% of the population will have experienced unpleasant migraine. Migraine is again more common in women, particularly those between 20 and 50 years of age, where it is believed that they are linked to hormonal changes.
Migraine is often set off by stress or tension, but there are other common triggers such as dehydration, missed meals, alcohol, loud noise, bright lights, cheese and chocolate to name a few.
Migraines are sometimes recurrent in nature and accompanied by moderate to severe pain. The headache will often affect one side of the head and can last for up to three days.
These headaches are unpleasant as they are often accompanied by symptoms such as nausea and vomiting and a dislike of loud noises or bright lights. Up to one third of migraine sufferers will experience other unpleasant symptoms known as an “aura” and this aura acts as a warning that the migraine is approaching.
The aura symptoms may include visual changes, such as bright lights or zig-zag lines, numbness or tingling. An important general principle in migraine management is to have regularity in one’s lifestyle.
Avoiding extremes is a good principle, whether it is becoming overtired, sleeping in, skipping meals, overeating or too much exertion. Regular sleep, diet and exercise are good practice for most migraine sufferers.
The third, less frequent type of common headache, known as a cluster headache, will affect around one in 1,000 of the population. Unlike the other two headaches, cluster headaches are more common in men, especially those who smoke.
The symptoms are generally a severe pain that is intense in nature and often centered around one eye. Cluster headaches can be experienced several times a day and the pain can last for up to three hours. Other common symptoms of cluster headaches include a watery eye, sweating and a runny or blocked nose.
There are of course other types of headaches, and other causes such as trauma, circulatory problems or overuse of some medicines.
Most headaches are nothing to worry about, however it is important that people who have severe or regular headaches discuss their condition with their GP or pharmacist in these circumstances.
Pharmacists are trained to help and to provide advice on appropriate treatment and they will refer people to their GP when they feel this is appropriate.
While the most appropriate painkiller will depend on the type and cause of the headache, I will always advise patients to take a painkiller immediately a headache is experienced.
There are a number of treatments on the market, and sometimes if one treatment does not work effectively, I will encourage my patients to try another or sometimes a combination of products.
In addition, many patients may benefit from other measures such as using cooling pads. There are products specifically designed for the treatment of migraine headaches which also help to reduce the nausea often associated with this type of headache.
It is not only medication that I would advise. I will also work with my patients to try to understand what may be causing the headaches and whether changes to lifestyle can help stop the headaches from occurring in the first place.
There are, as we all appreciate, a number of rare but potentially serious causes of headache, which have to be ruled out and your pharmacist will be alert to symptoms that require referral.
Although headaches can be very disabling, they are not in the main life-threatening. Effectively managing your headache can improve your quality of life. It is well-recognised that worrying about what might be causing your headache will simply serve to make it worse, when medical reassurance is often all that is needed.
If I was asked for one piece of advice, I would always advise people to ensure they drink plenty of water and keep hydrated throughout the day.
Indigestion is another common condition that can affect people at this time of year, as this is the time when stress levels increase, many people are short of time and food consumption is higher and more indulgent than usual.
It usually occurs when your stomach becomes irritated or upset, or when acid from your stomach flows back up the oesophagus. This is known as reflux.
You can get indigestion at any time, although it is more commonly experienced after meals. Symptoms
of indigestion commonly experienced are heartburn, pain, fullness, loss of appetite, nausea and flatulence.
Depending on the cause of your indigestion, your symptoms may pass quickly or they may be regular and more persistent.
There are a number of situations in which the likelihood of experiencing indigestion increases, such as increased stress, pregnancy, smoking, drinking, caffeine and even some medicines are recognised triggers of indigestion.
Some people may have underlying medical conditions that are causing the indigestion or heartburn and these are best looked after in partnership with your GP.
Pharmacists have a wide range of medicines at their disposal to deal with indigestion. These medicines include antacids, agents to reduce reflux, medicines to reduce the amount of acid that is produced by the stomach or to help to stop the stomach from producing acid in the first place. Your pharmacist is well-placed to help you choose the most appropriate product for your condition.
As with any minor ailment, it is important to recognise that there may be signs and symptoms that make referral to a GP the appropriate response and pharmacists are well aware of these.
The key things that I look out for are unexplained weight loss, unexplained and continuous symptoms particularly in older people, severe pain or the patient mentioning things like about specks of blood in their vomit.
It would not be appropriate to end without reminding readers that the Covid virus is still around and if we do decide, as many of us will, to spend time in the company of others, it is still possible to do so without getting overly close and to make sure we wash our hands regularly throughout the day and especially before eating, tempting as that chocolate may be.
I would like to wish all readers and their families a very Merry Christmas and a Happy New Year.