Heartburn

Advised:

Consider raising the head off the bed

Eat dinner well before bedtime

Address lifestyle risk factors:- Smoking?

- Alcohol?

- Caffeine?

- Chocolate?

- Fatty foods?

Trial antacid or alginate

Acupuncture (some limited evidence that it may be of help

?PPI:

(Notes: Now commonly used and overall generally thought to be safe (latest advice from UKTIS here), overall safety data is reassuring, however, need to note data is very limited for PPIs other than omeprazole, SPC for omeprazolestates it can be used in pregnancy, limited evidence PPIs may be effective in pregnancy but NICE assessed that the evidence was of low quality and not good enough to make recommendations about use)

Symptomatic vaginal discharge

Advised:

Common and reassured if no other symptoms

If associated with itching, soreness, unpleasant smell or dysuria: consider vaginal swab if the cause is not clear (if the cause is clear (eg typical thrush) investigation may not be needed)

If STI is possible: refer for an STI screen

Vaginal candidiasis:

Use topical azoles eg clotrimazole or econazole (PHE/NICE guidance suggests 7 day courses are more effective than shorter courses)

Bacterial vaginosis:

Oral or vaginal antibiotic treatments are BOTH recommended

Pelvic girdle pain

Referral to 'physiotherapy services' rather than a physiotherapist per se for exercise advice and/or non-rigid lumbopelvic belt

Resource(s):

NICE NG201