A to Z of Medical Conditions

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Hemochromatosis – the signs and symptoms

Hemochromatosis

Hemochromatosis

Symptoms

Symptoms of haemochromatosis usually begin between the ages of 30 and 60, although they can occasionally occur earlier.

The symptoms tend to develop earlier in men than in women. Women often don’t experience problems until after the menopause.

Sometimes there are no symptoms and the condition is only found during a blood test.

Early symptoms

Initial symptoms of haemochromatosis can include:

feeling very tired all the time (fatigue)

weight loss

weakness

joint pain

in men, an inability to get or maintain an erection (erectile dysfunction)

in women, irregular periods or absent periods

These symptoms can have many different causes and may sometimes just be put down to getting older.

Later problems

As the condition progresses, it can also cause problems such as:

loss of sex drive (libido)

darkening of the skin – you may look permanently tanned

tummy (abdominal) pain and swelling

yellowing of the skin and eyes (jaundice)

feeling thirsty all the time and needing to pee frequently

severe pain and stiffness in your joints, particularly in the fingers

chest pain

shortness of breath

swelling of your hands and feet

an irregular heartbeat (arrhythmia)

in men, the testicles getting smaller

These problems are often caused by complications of haemochromatosis that can occur if the condition isn’t treated early on.

When to see your GP

See your GP if you have:

persistent or worrying symptoms that could be caused by haemochromatosis – particularly if you have a northern European family background, as the condition is most common in this group

a parent or sibling with haemochromatosis, even if you don’t have symptoms yourself – tests can be done to check if you’re at risk of developing problems

Talk to your GP about whether you should have blood tests to check for haemochromatosis.

Read more about how haemochromatosis is diagnosed.

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Gout – what are the signs and symptoms of gout

Signs and Symptoms of Gout

Signs and Symptoms of Gout

Symptoms of gout

The main symptom of gout is a sudden attack of severe pain in one or more joints, typically your big toe.

Other symptoms can include:

the joint feeling hot and very tender, to the point of being unable to bear anything touching it
swelling in and around the affected joint
red, shiny skin over the affected joint
peeling, itchy and flaky skin as the swelling goes down

 

The intense pain can make getting around difficult. Even the light pressure of a bed cover or blanket can be unbearable.

Which joints can be affected?

Gout can affect almost any joint and can occur in more than one joint at the same time.

The joints towards the ends of the limbs tend to be affected more often, including the:

toes – particularly the big toe joint

midfoot (where your shoelaces sit)

ankles

knees

fingers

wrists

elbows

If gout is left untreated, it’s likely to affect more joints over time.

Pattern of symptoms

Attacks of gout tend to:

occur at night, although they can happen at any time

develop quickly over a few hours

last between three and 10 days – after this time, the affected joint should start to return to normal, but the problem can persist if treatment isn’t started early

come back – you may experience attacks every few months or years

become more frequent over time if not treated

It’s difficult to predict how often attacks will occur and when exactly they will happen.

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Guillain-Barré Syndrome – why you need to know the signs and symptoms of Guillain-Barré Syndrome

Guillain-Barré Syndrome Signs and Symptoms

Guillain-Barré Syndrome
Signs and Symptoms

Guillain-Barré Syndrome

Guillain-Barré (pronounced ghee-yan bar-ray) syndrome is a very rare and serious condition that affects the nerves.

It mainly affects the feet, hands and limbs, causing problems such as numbness, weakness and pain.

It can be treated and most people will eventually make a full recovery, although it can occasionally be life-threatening and some people are left with long-term problems.

Guillain-Barré syndrome affects people of all ages, but your chances of getting it increase as you get older.

 

Symptoms of Guillain-Barré syndrome

Symptoms often start in your feet and hands before spreading to your arms and legs.

At first you may have:

numbness

pins and needles

muscle weakness

pain

problems with balance and co-ordination

These symptoms may continue to get worse over the next few days or weeks before they start to slowly improve. In severe cases, you may have difficulty moving, walking, breathing and/or swallowing.

Read more about the symptoms of Guillain-Barré syndrome.

When to get medical help

See your GP if you notice any of the early symptoms of Guillain-Barré syndrome, such as numbness or weakness.

Call 999 for an ambulance or go to your nearest accident and emergency (A&E) department immediately if someone:

has difficulty breathing, swallowing or speaking

can’t move their limbs or face

faints and doesn’t regain consciousness within two minutes

This is a medical emergency and the person needs to be seen in hospital as soon as possible.

Read more about how Guillain-Barré syndrome is diagnosed.

Causes of Guillain-Barré syndrome

Guillain-Barré syndrome is thought to be caused by a problem with the immune system, the body’s natural defence against illness and infection.

Normally the immune system attacks any germs that get into the body. But in people with Guillain-Barré syndrome, something goes wrong and it mistakenly attacks and damages the nerves.

It’s not clear exactly why this happens, but it can be triggered by:

an infection, such as food poisoning, flu or cytomegalovirus

a vaccination, such as the flu vaccine (but this is extremely rare and the benefits of vaccination outweigh any risk)

surgery, a medical procedure or an injury

Read more about causes of Guillain-Barré syndrome.

Treatments for Guillain-Barré syndrome

Most people with Guillain-Barré syndrome are treated in hospital.

The main treatments are:

intravenous immunoglobulin (IVIG) – a treatment made from donated blood that helps bring your immune system under control

plasma exchange (plasmapheresis) – an alternative to IVIG where a machine is used to filter your blood to remove the harmful substances that are attacking your nerves

treatments to reduce symptoms and support body functions, such as painkillers, a machine to help with breathing and/or a feeding tube

Most people need to stay in hospital for a few weeks to a few months.

Read more about how Guillain-Barré syndrome is treated.

Recovering from Guillain-Barré syndrome

Most people with Guillain-Barré syndrome make a full recovery, but this can take months or even years.

Some people won’t make a full recovery and are left with long-term problems such as:

being unable to walk without assistance

weakness in your arms, legs or face

numbness, pain or a tingling or burning sensation

balance and co-ordination problems

extreme tiredness

Therapies such as physiotherapy, occupational therapy and speech and language therapy can help you recover and cope with any lasting difficulties.

Very occasionally, Guillain-Barré syndrome can cause life-threatening problems such as severe breathing difficulties or blood clots. Overall, around 1 in 20 cases is fatal.

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Wolff-Parkinson-White syndrome – some signs and symptoms

Wolff-Parkinson-White syndrome

Wolff-Parkinson-White syndrome

 

Wolff-Parkinson-White (WPW) syndrome is a heart condition that causes the heart to beat abnormally fast for periods of time.

It’s a relatively common condition, affecting between one and three in every 1,000 people.

The cause is an extra electrical connection in the heart. This problem with the heart is present at birth (congenital), although symptoms may not develop until later in life. Many cases are diagnosed in otherwise healthy adults aged between 20 and 40.

Sometimes the extra electrical connection won’t cause any symptoms and may only be picked up when an electrocardiogram (ECG) test is carried out for another reason. In these cases, further tests will be done to determine if treatment is required.

Is it serious?

It can be scary to be told that you have a problem with your heart, but WPW syndrome usually isn’t serious.

Many people will have no symptoms or only experience occasional, mild episodes of their heart racing. With treatment, the condition can normally be completely cured.
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WPW syndrome can sometimes be life-threatening, particularly if it occurs alongside a type of irregular heartbeat called atrial fibrillation. But this is rare and treatment can eliminate this risk.

Symptoms of WPW syndrome

If you have WPW syndrome, you’ll experience episodes where your heart suddenly starts racing, before stopping or slowing down abruptly. This rapid heart rate is called supraventricular tachycardia (SVT).

During an episode, you may experience symptoms such as:

a pounding or fluttering heartbeat (heart palpitations)

feeling light-headed or dizzy

shortness of breath

chest pain

sweating

feeling anxious

finding physical activity exhausting

passing out (fainting)

These episodes can last for seconds, minutes or hours. Rarely, they can last for days.

How often they occur varies from person to person. Some people may have episodes on a daily basis, while others may only experience them a few times a year.

They normally occur randomly, without any identifiable cause, but they can sometimes be triggered by strenuous exercise or drinking a lot of alcohol or caffeine.

When to seek medical advice

If you haven’t been diagnosed with WPW syndrome, you should contact your GP or call NHS 111 as soon as possible if your heart starts beating unusually fast and you have any of the above symptoms.

Dial 999 for an ambulance if your symptoms are particularly severe or long-lasting.

If you’ve already been diagnosed with WPW syndrome and you experience an episode, first try the techniques you’ve been taught or take any medication you’ve been given (see below).

Dial 999 or go to your nearest accident and emergency (A&E) department if these measures don’t stop the episode within a few minutes, or if someone you know has WPW syndrome and collapses or faints.

What causes WPW syndrome?

When the heart beats, its muscular walls contract (tighten and squeeze) to force blood out and around the body. They then relax, allowing the heart to fill with blood again. This is controlled by electrical signals.

In WPW syndrome, there’s an extra electrical connection in the heart, which allows electrical signals to bypass the usual route and form a short circuit. This means the signals travel round and round in a loop, causing episodes where the heart beats very fast.

The extra electrical connection is caused by a strand of heart muscle that grows while the unborn baby is developing in the womb.

It’s not clear exactly why this happens. It just seems to occur randomly in some babies, although rare cases have been found to run in families.

Diagnosing WPW syndrome

If your doctor thinks you might have WPW syndrome after assessing your symptoms, they’ll probably recommend having an electrocardiogram (ECG) and will refer you to a cardiologist (heart specialist).

An ECG is a test that records your heart’s rhythm and electrical activity. Small discs called electrodes are stuck onto your arms, legs and chest and connected by wires to an ECG machine. The machine records the tiny electrical signals produced by your heart each time it beats.

If you have WPW syndrome, the ECG will record an unusual pattern that isn’t usually present in people who don’t have the condition.

To confirm the diagnosis, you may be asked to wear a small portable ECG recorder so your heart rhythm can be recorded during an episode. The recorder will trace your heart rate continuously over a few days, or when you switch it on at the start of an episode.

Treatments for WPW syndrome

In many cases, episodes of abnormal heart activity associated with WPW syndrome are harmless, don’t last long, and settle down on their own without treatment.

You may therefore not need any treatment if your symptoms are mild or occur very occasionally, although you should still have regular check-ups so your heart can be monitored.

If your cardiologist recommends treatment, there are a number of options available. You can have treatment to either stop episodes when they occur, or prevent them occurring in the future.

Stopping an episode

There are three main techniques and treatments that can help stop episodes as they occur. These are:

Vagal manoeuvres – techniques designed to stimulate the nerve that slows down the electrical signals in your heart. An example is the ‘Valsalva manoeuvre’, where you hold your nose, close your mouth and exhale hard while straining as if you’re on the toilet.

Medication – an injection of medicine such as adenosine can be given in hospital if vagal manoeuvres don’t help. It can block the abnormal electrical signals in your heart.

Cardioversion – a type of electric shock therapy that jolts the heart back into a normal rhythm. This may be carried out in hospital if the above treatments don’t work.

Preventing further episodes

Techniques and treatments that can help prevent episodes include:

Lifestyle changes – if your episodes are triggered by things such as strenuous exercise or alcohol, avoiding these may help. Your cardiologist can advise you about this.

Medication – daily tablets of medication such as amiodarone can help prevent episodes by slowing down the electrical impulses in your heart.

Catheter ablation – this procedure is commonly used nowadays to destroy the extra part of the heart causing the problems in the heart’s electrical system. It’s effective in around 95% of cases.

See treating supraventricular tachycardia (SVT) for more information about all the treatments mentioned here.

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Hyperacusis – the signs and symptoms

Hyperacusis

Hyperacusis

Hyperacusis is the name for intolerance to everyday sounds that causes significant distress and affects a person’s day-to-day activities.

The condition can vary quite a lot. For example, some people find loud noises extremely uncomfortable, some find certain noises particularly annoying, some develop a fear of certain noises, while others experience pain when hearing ordinary sounds.

Hyperacusis affects people of all ages and is quite common in children.

The condition may just be a minor nuisance for some, but for many it can have a major impact on their life.

 

Symptoms of hyperacusis

Hyperacusis can either start suddenly or develop gradually over time.

When someone with the condition hears noise, they may:

feel uncomfortable

cover their ears or try to get away from the noise

feel angry, tense, distressed, or anxious

experience pain – hyperacusis can be very painful for some people

Some people become afraid of sound and avoid noisy situations, causing them to become socially isolated. School and work life can also suffer as it can be very difficult to concentrate.

When to get medical help

Visit your GP if you have a severe sound intolerance. They can examine your ears and refer you to an ear, nose and throat (ENT) consultant or a hearing specialist (audiologist) for tests if necessary.

There are no tests that can definitively diagnose hyperacusis, but you may be asked to fill in a questionnaire about your symptoms and have a hearing test to determine what level of sound causes a reaction.

Treatments for hyperacusis

There are no specific medicines or operations that can treat hyperacusis, although treating any underlying cause may help resolve the problem.

If there’s no clear cause, specialist techniques to help reduce your sensitivity to noise may be recommended.

These therapies are widely available privately, and may be available on the NHS for people with severe or persistent hyperacusis. They should only be carried out by someone specially trained in the correct techniques.

Treatment may involve:

cognitive behavioural therapy (CBT) – this aims to help you explore and change the way you think about the troublesome noises to reduce distress, change your avoidance behaviour, and help you recover from your hyperacusis symptoms

counselling and education – to support you and help you learn more about your hyperacusis

sound therapy (desensitisation) – this aims to help desensitise your hearing over several months, using special noise generators either placed in the room or in your ears (similar to hearing aids)

lifestyle changes – including learning relaxation techniques, listening to calming music or sounds, not avoiding noisy situations, and not using earplugs or muffs (these may make your ears more sensitive)

Recent research suggests patients often feel CBT, counselling and education are the most effective treatments. Some people also found sound therapy helpful, but it wasn’t clear whether it provided any additional benefit.

You may also find it helpful to get in touch with a support group, such as the British Tinnitus Association and Action on Hearing Loss, to talk to other people with hyperacusis and share your experiences.

Causes of hyperacusis

The cause of hyperacusis is unclear. It has been linked with a number of other conditions, although many people with hyperacusis don’t have any other obvious problems.

Hyperacusis has been associated with:

tinnitus – hearing sounds that come from inside your body, rather than from an outside source

hearing loss – the brain may sometimes compensate for reduced hearing by amplifying signals coming from the ears

damage to the ear or brain – including from a head injury, ear surgery, exposure to loud noise, earwax removal, glue ear, and persistent ear infections

migraines

Bell’s palsy – a type of facial paralysis

Ménière’s disease – a disorder of the inner ear that causes a spinning sensation (vertigo), tinnitus, and hearing loss

depression and post-traumatic stress disorder (PTSD)

Addison’s disease – a rare disorder of the adrenal glands, which sit near the kidneys and produce important hormones

disorders affecting the brain – such as Williams’ syndrome or autism spectrum disorder

Hyperacusis can also be a side effect of certain medications. If you’re taking any medication, check the leaflet it comes with to see if hyperacusis is listed as a possible side effect.