The story of how one woman refused to be irritated by IBS…

You know the feeling…you are sat in a crowded room and your stomach groans with peculiar sounds, accompanied by excruciating cramps. You don’t know whether to sit it out or make a dash to the closest toilet and hope nobody is already occupying the adjacent cubicle.

This might sound like a humorous situation for a sitcom, but it is a fairly common experience for millions of people who have Irritable Bowel Syndrome (IBS), and it is certainly far from a laughing matter. In particularly, IBS at work can be a deeply distressing thing to try and fight, but can be managed with a proper understanding of the condition and what can be done to ease/avoid an occurrence of symptoms.

The gut disorder can result in a variety of symptoms, but common symptoms generally include: bloating, wind, stomach cramps, and most people with IBS have bouts of diarrhoea and/or constipation.

Evidence suggests that the majority of people with IBS first begin to develop their symptoms between the ages of 20 and 30. Symptoms often appear and disappear in bouts, commonly after eating certain foods and during times of stress.

For one sufferer however, the problems began at a much earlier age. Medical librarian Vicky Grant, 43, has been trying to cope with IBS symptoms since the age of 13.

Vicky, then in her 30s, was in a work meeting when she was struck down with the all too familiar feelings of the condition.

She recalls: “I didn’t know whether to make a dash to the bathroom or just sit it out and hope it would pass. I was coping with up to seven bouts of diarrhoea a day and it was really taking its toll on me. I decided to risk it and stay put, but I was concentrating so hard on staying in control that everything being said in the meeting passed over my head.”

Vicky’s life was severely restricted by her IBS. She adds: “I felt bloated, tired and fatigued. My weight was below 7st (I’m 5ft 3in). I’d lost so much weight and looked terrible – I’m sure people thought I had anorexia. It was also making me depressed. I’d tried every drug, complementary therapy and diet under the sun, some things helped a little but nothing made my symptoms manageable. I was just so fed up with being ill all the time.”

Vicky is not alone though and a tenth of all doctors’ appointments are for symptoms related to IBS, which many doctors find difficult to treat. After all, the exact causes are still unknown and even though patients suffer with uncomfortable and sometimes distressing symptoms, unlike other bowel diseases IBS does not leave the gut with any noticeable damage.

Treatments are often a case of trial and error; changes in diet are often advised and IBS patients are usually instructed to keep a food diary. This can pinpoint the main triggers, i.e. are dairy or wheat products causing a flare-up of symptoms? Psychological therapy is another option for patients, and a lot of people find relief with antispasmodic medicines such as Buscopan IBS Relief and Colpermin 100 Capsules.

It took years for Vicky to find the courage to see her GP, finally going to see him in her early 20s. “He told me I did have IBS and that in my case it was due to stress and advised me to tackle the stress,” she says.

“I didn’t think I was any more stressed than any of my friends and thought the stress I was under was at least partly due to coping with my IBS. I tried meditation, but it made no difference. Over the years my IBS left me feeling totally drained.”

Nothing seem to have much effect for Vicky’s symptoms so three years ago she took to the internet to search around for stories of other people’s experiences and what worked for them.

One thing that kept being mentioned was vitamin D. Vicky recalls: “One thing that kept cropping up online was how high-dose vitamin D supplements could help. I read one blog then reports from patients on forums talking about this – it was generating a lot of interest.”

From things she had read on the internet, Vicky decided to try taking vitamin D2 – a dose of the nutrient (1,000 international units), but she had little success.

“Then a work colleague who has multiple sclerosis mentioned that vitamin D3 from fish oils is closer to the type the body makes naturally and was more effective and should be taken at a higher dose,” says Vicky.

“So I switched to 4,000 international units a day of D3, which is a safe dose. Within days, my symptoms eased and progressively improved over the months. After years of symptoms, my diarrhoea, cramps, pain and bloating disappeared. I started to feel well, put on weight and my depression lifted. It was amazing. My symptoms would flare up again though, if I forgot to take it.”

It is believed vitamin D might work by boosting the immune system as well as the gut’s barrier. Dr Nick Read, chairman of the IBS Network’s medical advisory group, says there is evidence some types of IBS involve a low level of inflammation in nerve endings in the gut.

He comments: “Inflammation around the gut’s nerve cells may make the intestine more sensitive to food and stress. We can’t say vitamin D works as a treatment for IBS yet. Only a properly designed trial will establish whether it works or not.”

Julian Walters, professor of gastroenterology at Imperial College, London, says it could be ‘plausible’ that vitamin D has a role to play in IBS treatments, although warns: “We shouldn’t assume it will work. It could just be the power of placebo.”

Today is National Psoriasis Day – Don’t let the condition ruin your life!

A quarter of people in the UK suffering with the inflammatory skin condition psoriasis claim their relationship has ended because of the symptoms they were afflicted with.

New research shows that four in 10 people with psoriasis say they have been dumped after their partner found them unattractive. Furthermore, 16% of those with the skin problem have cancelled a date because of it and 15% refuse to go on holiday due to worries about having to show off skin.

The findings were part of a report published ahead of today’s National Psoriasis Day – a global event that aims to give an international voice to the 125 million people around the world who suffer with psoriasis/psoriatic arthritis. The day will also hopefully raise awareness of the psychological impact that living with the condition can have and letting those affected discuss the day-to-day impact of managing the chronic inflammatory condition.

The new research shows to some extent how some of the 1.8 million sufferers in the UK try and deal with a condition that has been nicknamed eczema’s ‘cousin’.

One in six sufferers say that their psoriasis has hindered their progress at work, whilst four in 10 psoriasis patients claimed others have had a repulsed look at them and over of half of sufferers have co-workers who behave differently around them.

Of the 125 million around the world effected by psoriasis, there are some celebrities in this total. Reality show star Kim Kardashian and supermodel Cara Delivingne, who have both previously spoken of their battles against the condition, explaining how it has impacted their careers.

Delevingne has even deliberated walking away from the catwalk if her psoriasis becomes too problematic.

When interviewed by W Magazine, she commented: “It only happened during the Fashion Weeks, which are, of course, the worst time of year for me to be covered in scabs. Psoriasis is an auto-immune disease, and I’m sensitive.”

Kardashian has also stress her fears for her career, saying: “My career is doing ad campaigns and swimsuit photo shoots. People don’t understand the pressure on me to look perfect.”

It can be underestimated the psychical and mental impact that the skin condition can have for those who have it, and Medical Specialists Pharmacy is fully supportive of awareness campaigns that will promote more knowledge, understanding, and empathy towards ‘lesser known’ ailments.

Psoriasis is a chronic, recurring skin disease that unfortunately is often a life-long problem, and an estimated 2% of the population in the UK. It causes red, flaky, patchy and scaly skin that is usually on the scalp, lower back, elbows and knees, but can appear  anywhere on the  body.

After developing psoriasis, those who have it find that it tends to come and go throughout their life and flare-ups can occur quite randomly. Most people are usually only affected in small patches, but these patches may be itchy and sore.

Psoriasis occurs when skin cells are replaced faster than at a normal speed. As yet, health experts have not yet fully established why this can happen to some people. However, it is generally believed there are probably a mixture of reasons that cause it, such as genetic predisposition and environmental factors.

For instance, approximately one in three people with psoriasis also has a close relative who has the condition. A lot of people with psoriasis will see their symptoms begin or become worse due to ‘triggers’, including: smoking, alcohol, stress, a skin-related injury such as a cut, scrape, insect bite or sunburn (known as the Koebner response) and certain medications.

T/Gel is recommended by dermatologists for chronic scalp psoriasis treatment, seborrhoeic dermatitis and even common dandruff. Clinical tests have shown the active ingredients in T/Gel carry on working for hours after the shampoo has been rinsed off, and also works to leave hair looking healthy and manageable.

Stroke rates among younger people should act as ‘a wake-up call’

An increasing number of young to middle aged people are suffering from strokes around the world because of their unhealthy lifestyle, according to findings from a new study.

Spiralling rates of obesity and diabetes, together with lack of exercise, has caused a rise to the number of strokes effecting people aged between 20 and 64. In fact, the number has increased by a quarter in merely 20 years, calling health experts to label the worrying situation a ‘stroke epidemic’.

Strokes afflicting this age group now comprise of 31% of the global total, whereas in 1990 it was only 25%. Stroke rates among children and young people aged 20 and under have also been studied and even among this age group researchers discovered that there are over than 83,000 cases each year; 0.5% of the total number.

The findings, published in the latest issue of The Lancet, stem from a systematic analysis of data extracted from 50 countries on the causes of illness and major diseases.

Although the analysis demonstrated a decrease in deaths from stroke in the UK, Brits are still more likely to die after suffering a stroke compared to those living in France, Germany and even the U.S.
Those living in less well-off countries are also much more at risk of succumbing from a stroke, with 42% more deaths across poorer countries during 1990 to 2010 in comparison to well-off nations. Over those two decades, stroke rates dropped by 12% in the richer countries.

Numerous lifestyle risk factors are thought to be the result of increasing stroke rates in the low to middle-income countries. For example, smoking, high blood pressure (hypertension), lack of exercise and an unhealthy diet have all been pin-pointed as risk factors.

Stroke Association chief executive Jon Barrick said that the findings of the research were a “wake-up call to governments across the globe”.

Mr Barrick said: “The report reveals a shocking disparity between rich and poor, where death rates from stroke are up to 10 times higher in lower income countries,” Mr Barrick said. Closer to home, within the UK, the number of people dying from stroke is around three times higher in the most economically deprived areas, compared to the least deprived. To help close this health inequality gap, we need more investment in stroke prevention and research.”

He added: “Rising obesity and diabetes rates, coupled with sedentary and unhealthy lifestyles, could wipe out the improvements we’ve seen in reducing stroke mortality in the UK, putting even more pressure on our limited NHS resources. This is a stark warning. We urgently need to address this global stroke crisis by prioritising stroke prevention and investment into stroke research.”

Lead scientist Professor Valery Feigin, director of the National Institute for Stroke and Applied Neurosciences at AUT University in New Zealand, commented: “The worldwide stroke burden is growing very fast and there is now an urgent need for culturally acceptable and affordable stroke prevention, management and rehabilitation strategies to be developed and implemented worldwide.”
Every year there are an estimated 152,000 strokes that occur in the UK, costing the NHS around £3.7 billion.

Broadcaster Andrew Marr suffered a stroke in January 2013 at the age of 53, and recently returned to work. In September he spoke about his experiences, saying: “I thought I’d bounce back in a couple of months. I was lying in bed completely delusional about how ill I was, and [my wife] Jackie was very good, she didn’t tell me. She kept saying, ‘Yes, dear, you’ll get to go to St Petersburg in March, I’m sure it’s going to be fine,’ knowing perfectly well that it wouldn’t. So it took quite a long time for it to sink in just how long it would be. I’ve got another two years before I’ve made a recovery.”

The political journalist has drew strength and positives from what he has gone through, and said: “You definitely see the world differently, actually, that is true. You move more slowly. You suck up experiences more intensely and you live the day more.”

He added: “And you’re much more aware of all the people all around us who have got really, really difficult disabilities who are looking after their parents, perhaps, and who frankly most of the time, like most people, I simply didn’t see. I wasn’t thinking about them. That has changed. I do see them now, I do think about it.”

Celebrity hair loss stories: The bald truth uncovered!

Hair loss is one of the most common conditions in the world – Male pattern baldness being the most common form of hair loss, affecting an estimated 6.5 million men in the UK alone.

However, there are many types and causes of hair loss, and whether it is affecting a man or woman, can create a large degree of anxiety and loss of self-esteem.

With today’s media becoming increasingly fixated on celebrity’s fluctuations in weight, fashion choices, love life developments, and other scrutinising of their life, any slight amount of hair loss will be reported – and fast.

In this regard, it should offer some comfort for the millions of men and women around the world with hair loss to know that celebrities are just human like the rest of us. They are not superhuman and are still susceptible to problems and conditions like everybody else. You cut them, they bleed.

In recent years celebrity hair loss stories, gossip, etc. are becoming more common and in the last 12 months alone we have heard questions asked about Wimbledon champion Andy Murray losing hair and even pop superstar Justin Bieber saying Prince William should use the hair loss treatment Propecia.

We have also heard from some celebrities themselves who are experiencing a varying scale of hair loss, for a variety of reasons. Here we recall some of the other celebrities with hair loss and what they had to say about their experience.

. Wayne Rooney (footballer)

Manchester United striker Wayne Rooney announced himself to the world stage in 2002, when the then 16-year-old scored a last-minute wonder goal for Everton against Arsenal. In subsequent years, the pressure of playing for one of the biggest clubs in the world and allegations about his private life appear to have affected his hair and Rooney has been battling hair loss for a number of years.

In June 2011, Rooney confirmed he had undergone a hair transplant, tweeting: “Just to confirm to all my followers I have had a hair transplant…I was going bald at 25, why not? I’m delighted with the result.”

Since that expensive £30,000 transplant, Rooney’s hair has thinned yet again and earlier this year he had a second ‘top-up’ transplant at the same London Harley Street clinic. However, some have speculated that Rooney could have saved himself a lot of money if he had acted sooner and perhaps used a combination of medically proven treatments to prevent further hair loss and promote hair growth, such as Propecia and Regaine (respectively). Just because something costs an absolute fortune, it doesn’t necessarily mean it is guaranteed to do the business…there are plenty of overpaid footballers as evidence for this!

. David Beckham (retired footballer)

Retired footballer and global superstar David Beckham has tried countless weird and wonderful hairstyles over the last 15 years and has been known to reach for the blonde hair dye on occasions too. The ill-fated cornrows is just one memorable change to his hair which will have added to the strain he has undoubtedly placed on his follicles through the years. Although there has been noticeable recession at the temples, Beckham still retains a decent head of hair for a man pushing 40 years of age. He has never publically admitted to using any particular product or medication to hold on to his hair, but there have been whispers of a hair transplant.

Beckham has admitted his fears of losing his hair, and in 2012 when asked if he had undergone a hair transplant, or would consider one in future years, he said: “Someone said I’d had a hair transplant. There’s definitely nothing wrong with doing that, but I don’t think personally I would. If I do start showing signs of going bald, then I will shave it off. I’ve still got hair. I’m still fighting it.”

. Will Young (singer)

Will Young was just 23 years of age when he beat Gareth Gates to win the UK Pop Idol in 2002. Back then it was clear he was having slight recession in his hair, which slowly progressed over the subsequent years. Unusual for a celebrity, Young has been open and honest about his battle to beat hair loss. He quashed rumours of a hair transplant after his hairline and hair thickness started to improve, instead crediting the medication Propecia for the turnaround.

He spoke of his hair loss in 2009, saying: “I love my hair – my barber, Paul, has given me a 50s style with a bit of a quiff. I take Propecia pills for my hair, because I started losing it four years ago. It’s a horrible thing – it’s emasculating and you just feel you aren’t sexy any more. The pills worked and my hair grew back.”

 . January Jones (actress)

Back in January of this year the Mad Men actress revealed that consistently dying her hair had triggered hair loss. The star, who plays Betty Draper on the hit TV series, has been a brunette, redhead and blonde during her career thus far.
She commented earlier this year: “I have been every colour and now my hair is falling out in clumps. I’m going to have to shave it off and wear a wig. I like it all colours, it makes you feel different according to what colour it is, but I prefer to be blonde.”

. Selma Blair (actress)

Another American actress to suffer with female hair loss is Selma Blair, and no…not from the stress of trying to get along with Charlie Sheen during the filming of ‘Anger Management’. After giving birth to son Arthur in 2011, Selma was photographed less than six months later with her scalp quite visible around her hair parting. Many new mothers suffer with hormonal hair loss due to decreased estrogen levels, but the problem usually subsides after six months.

Speaking about the problem at the time, Selma said: She said: ‘”This is so not glamorous, but it’s true: I need to take longer showers so that I can collect the hair that falls out and throw it away so I don’t clog the drain. Why do actresses never talk about that? It just started falling out at the three-month mark. And I’m not a girl who likes extensions, so Selma’s going to be bald!”

Forged Viagra prescription lands conman with fine and suspended prison sentence

A clumsy man learned the hard way that forging prescriptions does not pay, although his careless actions landed him with £85 costs, a £80 victim surcharge and he was also sentenced to four months in prison, suspended for a year.

Mahfooz Ulhaq, 45, of Aspley Park Drive, Aspley, attempted to add the popular erectile dysfunction medication Viagra to his two prescriptions for other drugs. The somewhat ludicrous mistakes made it immediately obvious though that something was suspicious to the sceptical pharmacists.

Not only had Ulhaq tried to scribble something resembling his doctor’s handwriting – and failing miserably – but he had comically misspelt Viagra and had actually scribbled “100ml” instead of the correct dosage of 100mg. As most people know, Viagra is manufactured in a tablet form, shaped like a diamond, and is often referred to as ‘the little blue pill’.

Falsifying prescriptions for prescription-only medication is no laughing matter however, and Ulhaq’s suspended prison sentence reflects this.

Ulhaq stood up in the dock at Nottingham Magistrates’ Court and admitted the two charges of making false prescriptions with the intention of gaining pharmaceutical drugs.

Neil Hollett, prosecuting, described how Ulhaq had first attempted to obtain the drugs from the City Hospital’s outpatients’ pharmacy and failing that, then from a nearby Boots pharmacy.

“On the first occasion a member of staff brought to the attention of the pharmacist that the defendant was back to collect some medication he already had,” he said.

“They could see the doctor’s handwriting had been overwritten and other medication added on the prescription. It also contained spelling errors. It was shown to the doctor who had prescribed it and found to be fraudulently altered.”

Mr Hollett also commented how another member of staff had said Ulhaq asked for disguised bottles to be used in the dispending of his medication as ‘he didn’t want his family knowing what he was diagnosed with’.

The second attempted acquisition of Viagra saw Ulhaq drop off a prescription and say he would be back the next day to collect his medication.

However, upon closer inspection of the prescription given by Ulhaq, the member of staff noticed a glaring error – it stated 100ml instead of 100mg (an actual Viagra dosage). “They believed it had been altered”, said Mr Hollett.

The next day when Ulhaq returned to collect his medication he was met with a firm refusal after the prescribing doctor had confirmed suspicions that the inclusion of Viagra had indeed been falsified.
Unsurprisingly, Ulhaq was arrested, admitting to police he had written on both prescriptions but bizarrely claimed he had no intention of getting the Viagra.

His excuse was flimsy at best, claiming he had lost another prescription and had written on those ones to remind himself what had been on there.

Chris Brewin, in mitigation, said: “Mr Ulhaq is extremely unwell. He has spinal problems which affect his mobility. Daily life for Mr Ulhaq is extremely difficult. He was prescribed Viagra but what happened was the separate prescription became soiled, and the solution was to add Viagra to another prescription. He knows this was wrong. He is very disappointed to find himself back before the court.”

Magistrate Patricia Boyce-Forgenie concluded: “It is very serious. You are on a lot of medication and do not know how Viagra would have interacted with the other medication. It was very risky thing to do.”

Scientific breakthrough made for hair loss treatments

A new breakthrough by British scientists has raised hope for those suffering with hair loss, and the therapy may even provide help to victims of burns.

The results of the tests could pave the way for more hair loss treatments for both men and women, after results demonstrated it was possible to grow new hair follicles from human skin cells – basically the cells that contain the ‘instruction book’ for growing new hair.

Tests are still at an early stage, but the scientists from Durham University in the UK and Columbia University in the U.S. claim that their findings represent a huge breakthrough in treating hair loss that effects millions of men and women around the world, often causing a great deal of distress.

Not only this, but it seems a 40-year wait could be over in the futile efforts to successfully regenerate the crucial structures in the skin that enable hair to grow.

Human hair follicles are incredibly difficult to replicate in a laboratory environment, but the new technique has shown evidence they can be stimulated to grow in skin tissue and also to generate hair shafts.

Currently, expensive hair transplants notoriously used by footballer Wayne Rooney involve the surgeon transplanting hair follicles from the back of the head (where there is plentiful hair) to where it is needed at the front. Therefore, they are simply redistributing already present hair compared to the new technique which could significantly boost the amount of hairs on the head.

Columbia University researcher Dr Angela Christiano, herself a sufferer of alopecia and experiences clumps of hair falling out, said the research “has the potential to transform the medical treatment of hair loss”.

“Our method…has the potential to actually grow new follicles using a patient’s own cells. This could greatly expand the utility of hair-restoration surgery to women and to younger patients – now it is largely restricted to the treatment of male-pattern baldness in patients with stable disease. It could make hair transplantation available to individuals with a limited number of follicles, including those with female-pattern hair loss, scarring alopecia and hair loss due to burns,” she said.

The team of scientists started extracting tiny cells called dermal papillae from strips of human hair cells. These cells are located at the base of a hair and contain the ‘instruction book’ for the successful growth of new hair.

Next, they cloned the cells in a dish, making sure they had several copies of each cell. Similar procedures have been done previously but without any results in getting the cells grow hair after they have been put back into skin.

The Anglo-American team decided to turn the dish of cells upside down, to help them to form into the clumps found in nature. These clumps were transplanted into human skin grafted onto the backs of mice.

It was found that the cells from each of the seven human donors grew hairs and in some cases, the tufts broke through the skin.

Although the hairs were white in colour, Durham researcher Professor Colin Jahoda is optimistic it should be possible to create coloured hair and by using a sample of a person’s own cells, any new hair should be very similar in texture and curliness.

“It’s a key step because it is saying that you can multiply the process. It’s not just about one-for-one replacement. But you need to get hair that is the right colour and texture and this will need further work before human clinical trials can begin,” he said.

The cost to patients is still yet to be determined as clinical trials need to be carried out first. However, it is likely to be cheaper than hair transplants which can range anywhere in price from £6,000 all the way up to £30,000 per patient.

Website showing ghastly effects of smoking is launched as Stoptober enters final week

As we enter the final seven days of the Stoptober challenge, Medical Specialists Pharmacy would like to say a huge well done to the thousands of you who have made it this far and good luck in your quest to hopefully remain smoke-free for the rest of 2013 and beyond!

Stoptober is basically just October…without the cigarettes! Health experts say that if you stop smoking for 28 days you are in fact five times more likely to actually remain smoke-free for good!

Almost 21,000 followers have been amassed on the Stoptober Twitter page, as fellow smokers encourage each other on through the month.  In addition to helping each other with words of encouragement, smokers can still receive their free support pack as well as regular text messages that help to keep you focused, daily emails packed full of useful tips and advice, and there is even an interactive mobile app for iPhone and Android smartphones.

If you still need reasons or motivation to quit, this month has seen the interactive website ‘Tobacco Body’ launched by Finnish doctors in conjunction with the Cancer Society of Finland.

Users can first select the female or male body, and then browse through different areas such as ‘acne’, ‘face’, ‘hair’, etc. to see quite disturbing effects of smoking. It is plainly obvious to see the damage when the healthier non-smoker’s portion of the body is juxtaposed against the post-smoking side.
If it’s not bad enough that looks are severely impacted, smokers are at double the risk of a blood clot and usually have a worsened sex life. Male smokers have decreased blood flow to the penis, and are twice as likely as non-smokers to suffer with erectile dysfunction.

Smokers’ sperm density is also negatively affected, with the toxins in cigarettes diminishing both concentration and mobility of sperm cells in semen, harming the cell’s structure, according to the website.

With regards to skin, the website explains “smokers are more likely to get spots as smoking weakens the circulation which increases the risk of infection. It also make acne more difficult to deal with.”
Women smokers may not be aware of this fact, but the site also describes that smoking can actually cause hair growth on the face and arms as smoking increases levels of the male hormone, testosterone. However, there is good news in that acne and excessive hair growth in women can be treated through medications such as Dianette or Yasmin.

One person who is well on the way to permanently stubbing out cigarettes is Mike Wellings, finance director at Great Western Hospital in Swindon.

Mike, a bit fitness fanatic, was finding his stamina being limited because of smoking, saying: “I play lots of sport but I’ve found that smoking really impacts my performance. There’s also the combination of family pressure and health reasons. And, of course, I work in a hospital and it’s important to set an example.”

Like so many who wish to quit smoking, Mike decided to turn to the smoking cessation medication Champix to get him through Stoptober and beyond.

He explained: He said: “I actually started the course on the Sunday before Stoptober started. I used to smoke about 20 a day and now it’s gone down to about three. Champix makes it taste disgusting. And I’ve been drinking lots of fluids to combat the cravings too. I’ve been smoking for nearly 30 years. I tried quitting before, about four years ago when I was in Doncaster, and I managed to stop for three months. Then one day work got the better of me and I had a cigarette.  Everyone has been really supportive this time. I’m taking it just one day at a time.”

If you are a smoker who is aged 18 or above and wants to quit, you can quit today with the help of Medical Specialists Pharmacy. You can obtain the smoking cessation medication Champix following an online consultation with one of Medical Specialists’ GMC registered doctors. Champix works out from as little as just £75.00 per pack and mimics the effect of nicotine on the body, and as Mike Wellings discovered, decreases the enjoyment of smoking if you decide to have a cigarette whilst on the treatment.