Are there veins in the abdomen?

Abdominal Veins: A Deep Dive into the Vital Network in Your Tummy

Description: Ever wondered what's happening beneath the surface of your abdomen? Join us for a comprehensive look at the complex and vital network of veins in your tummy, exploring their anatomy, function, and common issues in plain British English.

 

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Abdominal Veins: A Deep Dive into the Vital Network in Your Tummy

Right then, settle in, put the kettle on, and let's have a chinwag about something rather marvellous and absolutely essential tucked away inside you: the veins in your abdomen. It’s a question that might pop into your head – perhaps you’ve seen a prominent vein on the surface, or maybe you’ve just had a ponder about what plumbing keeps everything running smoothly inside your core.

The short answer, straight up? Yes, absolutely! Your abdomen is brimming with veins, a complex, bustling network responsible for some incredibly critical jobs. But like so many things inside the human body, it’s far from simple. These aren’t just any old veins; they’re a mix of major superhighways and intricate little lanes, each playing a specific, vital role in keeping you ticking over.

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Think of your abdomen – your 'tummy' or 'belly' as most of us call it in Blighty – as the body's central processing unit and distribution hub, all rolled into one. It’s where digestion happens, where vital organs like the liver, kidneys, stomach, and intestines reside. And just like any busy city or industrial complex, it needs a seriously efficient transport system. While the arteries are busy bringing in the fresh supplies (oxygenated blood), the veins are the workhorses, collecting the used goods (deoxygenated blood, waste products, and rather uniquely in the abdomen, absorbed nutrients) and shipping them off for processing or disposal.

So, while you might be more familiar with the veins you can see on your hands or legs, the ones tucked away deep inside your abdomen are arguably doing some of the most complex and crucial work. They’re out of sight, but certainly not out of mind for anyone who understands human anatomy or, indeed, anyone who has experienced issues related to them.

In this rather lengthy but hopefully engaging exploration, we're going to take a proper gander at these abdominal veins. We'll peel back the layers (metaphorically, of course!) and look at the main players, understand what makes them so special, discuss their absolutely vital functions, and touch upon what can happen when this intricate system hits a bit of a snag. It's a fascinating journey into the hidden architecture of your body, presented with a good dose of British pragmatism and wonder.

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The Abdomen: A Truly Bustling Junction

Before we dive headfirst into the veins themselves, let's just take a moment to appreciate the sheer complexity of the abdominal cavity. It's not just a big, empty space; it's packed, and rather efficiently too, with organs essential for life:

• The Stomach: Where food begins its breakdown journey.
• The Small and Large Intestines: The epicentre of digestion and absorption.
• The Liver: A massive, multitasking organ – filtering blood, producing bile, metabolising nutrients, detoxifying substances, and much, much more.
• The Gallbladder: Storing bile from the liver.
• The Pancreas: Producing digestive enzymes and hormones like insulin.
• The Kidneys: The body's incredible filtration system, producing urine.
• The Spleen: Part of the immune system, filtering blood.
• Parts of the Aorta and Inferior Vena Cava: The body’s largest artery and vein, respectively, passing through.

Phew! That's quite the list, isn't it? And every single one of these organs, plus the muscles and tissues that make up the abdominal wall and support structures, needs a constant supply of blood and a way to get rid of waste and used blood. This is where the veins step in, forming the essential drainage network.

Yes, Absolutely! Veins Galore (and Why They're Different Here)

Let's reiterate the core answer: Yes, your abdomen is crisscrossed with veins. Lots of them. From tiny venules collecting blood from the capillary beds of the organs to massive vessels channeling blood towards the heart.

Now, the primary job of most veins in the body is straightforward: carry deoxygenated blood from the tissues back to the heart (specifically, the right atrium). This used blood is then pumped to the lungs to pick up oxygen, and then it's sent back to the heart to be pumped out via the arteries again. A neat, continuous loop.

However, the venous system in the abdomen has a rather significant, unique twist, primarily thanks to the digestive system and the liver. This twist is known as the Hepatic Portal System. It's a bit like a special courier service with a mandatory stop at a processing plant (the liver) before the goods are allowed to proceed to the main distribution centre (the heart).

This complexity is what makes understanding abdominal veins so fascinating and so important. They aren't just passive pipes; they're integral to metabolism, detoxification, and nutrient distribution.

The Grand Superhighways and Intricate Byways: Key Abdominal Veins

To truly appreciate the abdominal venous system, we need to get acquainted with some of the main players. Think of this as a guided tour of the key routes on the abdominal circulatory map. We'll start with the biggest drainage channel and then look at the crucial special-purpose network.

The Inferior Vena Cava (IVC): The Main Southern Drain

Imagine all the blood from your legs, feet, pelvis, lower back, and most of your abdominal organs needing to get back up to your heart, which is situated in your chest. The mighty Inferior Vena Cava (IVC) is the colossal vessel responsible for this enormous task.

• Where it is: It's a massive vein that runs vertically up through your abdomen, just to the right of your spine. It starts down in the pelvis where the common iliac veins (draining the legs and pelvis) merge, and it travels upwards, receiving blood from various abdominal veins along the way, before passing through the diaphragm (the muscle separating your chest and abdomen) and emptying into the right atrium of your heart.
• What it does: It's the primary collector vein for the lower half of the body. Every drop of deoxygenated blood returning from below the diaphragm, except for the blood handled by the initial part of the portal system (which we'll get to!), eventually finds its way into the IVC.
• Size matters: The IVC is the largest vein in the body, reflecting the sheer volume of blood it handles. It’s quite a spectacle, anatomically speaking.

Several important veins drain directly into the IVC within the abdomen. These include:

• Renal Veins: These are substantial veins that drain the kidneys. There's one from each kidney, joining the IVC horizontally. The left renal vein is particularly interesting as it's longer and passes behind the superior mesenteric artery before reaching the IVC, a route that can occasionally cause issues (like Nutcracker Syndrome, where the vein gets compressed).
• Hepatic Veins: These are the final vessels of the hepatic portal system, but they connect the liver directly to the IVC. Once the blood has been processed by the liver, it enters the hepatic veins and then drains into the IVC, finally joining the general circulation towards the heart. There are typically three main hepatic veins (right, middle, and left).
• Lumbar Veins: These small veins drain blood from the muscles and skin of the posterior abdominal wall and the spinal cord. They run segmentally and drain into the back of the IVC.
• Gonadal Veins: These drain the gonads – the testicular veins in men and ovarian veins in women. The right gonadal vein usually drains directly into the IVC, while the left gonadal vein typically drains into the left renal vein, which then drains into the IVC. This anatomical difference is why varicoceles (varicose veins in the scrotum) are far more common on the left side.
• Suprarenal (Adrenal) Veins: These drain the adrenal glands, small glands located on top of the kidneys. The right suprarenal vein drains directly into the IVC, while the left usually drains into the left renal vein.
• Inferior Phrenic Veins: These drain the underside of the diaphragm. The right one usually drains into the IVC, while the left might drain into the IVC or the left renal vein.

So, the IVC is like the main motorway heading north towards the heart, with many significant slip roads joining it along its abdominal stretch.

The Hepatic Portal System: The Body's Unique Processing Pipeline

Now, this is where things get really fascinating and distinctly different from the rest of the body's venous drainage. The hepatic portal system is a network of veins that collects blood not to send it directly back to the heart, but to ferry it from the digestive organs (stomach, intestines, pancreas, spleen) specifically to the liver.

• Why the deto_ur_? This is the clever bit. After you eat, your intestines absorb nutrients – sugars, amino acids, fatty acids (mostly via the lymphatic system initially, but then entering the bloodstream), vitamins, and minerals. They also absorb things that might not be so good, like toxins or drugs. If all this blood went straight back into the general circulation, your body would get a massive, unprocessed hit of whatever you've just consumed, good or bad. The liver acts as a crucial processing plant and filter. It:
• Processes and stores nutrients (e.g., converting glucose to glycogen).
• Detoxifies harmful substances.
• Metabolises drugs.
• Removes bacteria and other pathogens absorbed from the gut.

Only after the liver has done its job is the blood then allowed to join the general circulation via the hepatic veins draining into the IVC.

• Key Players in the Portal System: The hepatic portal system is formed by the convergence of several major veins:
• The Superior Mesenteric Vein (SMV): This large vein collects blood from the small intestine (where most nutrient absorption occurs), the caecum, the appendix, the ascending colon, and part of the transverse colon. It runs upwards in the abdomen.
• The Splenic Vein: This vein drains blood from the spleen (which, while not digestive, is closely associated and its blood joins this system), the stomach, and the pancreas. It runs horizontally across the abdomen, behind the pancreas.
• The Inferior Mesenteric Vein (IMV): This vein collects blood from the descending colon, sigmoid colon, rectum, and anal canal. Interestingly, the IMV doesn't usually join the portal vein directly; it typically drains into the splenic vein, which then joins the SMV.
• The Portal Vein (or Hepatic Portal Vein): This is the main vessel of the system. It's formed behind the neck of the pancreas by the merging of the Superior Mesenteric Vein and the Splenic Vein. The Inferior Mesenteric Vein usually joins the Splenic Vein just before this merger. The portal vein then travels upwards, entering the liver and branching like a tree within the liver substance.

So, blood from most of the digestive tract and the spleen is collected by these feeder veins, which merge to form the portal vein. The portal vein then carries this blood into the liver for processing. After processing within the liver's sinusoids (tiny blood vessels), the blood is collected by the hepatic veins, which then drain into the IVC. It's a 'vein-capillary bed (in liver)-vein' system, which is quite unique compared to the typical 'artery-capillary bed-vein' pathway found elsewhere.

Veins of the Abdominal Wall

While we've focused on the deep internal veins, it's also worth noting that the abdominal wall itself has a network of veins draining the skin, muscles, and connective tissues. These include the superior and inferior epigastric veins (accompanying the similarly named arteries) and superficial veins visible just under the skin, particularly around the navel (umbilicus). These superficial veins connect to deeper systems, including the portal system via small veins around the navel (paraumbilical veins) and also drain upwards towards veins in the chest (like the superior vena cava system) and downwards towards the IVC via the femoral veins.

This connection between superficial abdominal veins and the portal system is crucial because if there's a blockage in the portal system (e.g., due to liver cirrhosis), the blood can back up and cause these normally small paraumbilical veins to enlarge and become visible on the surface around the navel. This is a clinical sign known as "Caput Medusae," named after the snake-haired Gorgon from Greek mythology, as the engorged veins can look like snakes radiating from the navel. A rather striking, albeit concerning, visual cue.

Why Are These Veins So Absolutely Critical?

It's probably becoming clear already, but let's explicitly state why this abdominal venous network is so utterly vital for your health and survival:

1.    Nutrient Transport & Metabolism: The hepatic portal system is the body's sole route for delivering absorbed nutrients (carbohydrates, proteins, etc.) from the gut to the liver for initial processing, storage, and metabolism. Without this, your body couldn't efficiently use the food you eat, nor could it manage blood sugar levels effectively.

2.    Detoxification and Filtering: The liver, receiving blood via the portal vein, is the primary site for detoxifying harmful substances, including waste products produced by the body and toxins absorbed from the environment or digestive process. It also filters out bacteria and other pathogens that might have entered the bloodstream from the gut.

3.    Waste Removal: While the kidneys handle nitrogenous waste (like urea), the veins from other abdominal organs are essential for carrying away deoxygenated blood and other metabolic waste products, ensuring these substances are transported to the appropriate organs (like the kidneys or liver) for processing or excretion, or back to the heart/lungs for reoxygenation.

4.    Maintaining Blood Volume and Pressure: The veins, including those in the abdomen, play a critical role in the overall circulatory system, helping to regulate blood volume distribution and contributing to blood pressure regulation. The IVC, as the largest vein, handles a massive volume of blood return.

5.    Organ Function: Simply put, all the abdominal organs need a functioning venous drainage system to work correctly. If blood can't leave an organ efficiently, it becomes congested, leading to impaired function and potential damage.

So, these veins are far more than just simple drainage pipes; they are active, crucial participants in metabolism, detoxification, and maintaining the body's internal balance.

What Can Go Wrong? Common Issues Affecting Abdominal Veins

Like any complex system, the abdominal venous network can encounter problems. When things go awry, the consequences can range from mildly uncomfortable to life-threatening, depending on which vessels are affected and the nature of the issue. Here are some of the more common or significant problems associated with abdominal veins:

Portal Hypertension

This is arguably the most common and serious issue specifically related to the abdominal venous system, particularly the hepatic portal system. Portal hypertension means there's abnormally high blood pressure within the portal vein and its tributaries (the SMV, Splenic Vein, IMV).

• Causes: The most frequent cause in Western countries is liver cirrhosis (scarring of the liver), often due to chronic alcohol abuse, viral hepatitis (like Hepatitis C or B), or fatty liver disease. The scarred liver becomes stiff and obstructs the flow of blood coming from the portal vein. Less common causes include blood clots in the portal vein itself (portal vein thrombosis) or in the hepatic veins (Budd-Chiari Syndrome).
• Why it's a problem: When blood flow through the liver is blocked, pressure builds up in the portal system. This forces the blood to find alternative routes back to the systemic circulation, using smaller veins that aren't designed to handle such high volumes and pressures. These detours are called portosystemic collaterals.
• Consequences of Collaterals: The formation of these collaterals leads to several potential complications:
• Oesophageal Varices: The most dangerous consequence. Collaterals form in the veins of the lower oesophagus (gullet). These veins become enlarged and swollen (varices) and are very prone to bursting, causing severe, life-threatening bleeding.
• Gastric Varices: Similar to oesophageal varices, but occurring in the stomach lining. Also carry a risk of bleeding.
• Ascites: Fluid accumulation in the abdominal cavity. High pressure in the portal system, combined with the liver's reduced ability to produce albumin (a protein that helps keep fluid in the bloodstream), causes fluid to leak out of the veins into the abdomen. This can cause significant swelling and discomfort.
• Splenomegaly: Enlargement of the spleen, often due to blood backing up in the splenic vein.
• Hepatic Encephalopathy: When blood bypasses the liver through collaterals, toxins (like ammonia) that the liver would normally remove or process build up in the bloodstream. These toxins can affect brain function, leading to confusion, disorientation, and even coma.
• Caput Medusae: As mentioned earlier, visible engorgement of superficial veins around the navel as collaterals attempt to bypass the liver and drain towards systemic veins.
• Anorectal Varices: Varices in the rectum and anus, similar to haemorrhoids but caused by portal hypertension.

Portal hypertension is a serious condition that requires careful medical management, often involving medications to reduce pressure, procedures to band or sclerose varices, or in severe cases, liver transplantation.

Deep Vein Thrombosis (DVT) in Abdominal Veins

While DVT is most commonly associated with the legs, blood clots (thrombi) can also form in the deep veins within the abdomen.

• Which veins? This can occur in the IVC, the iliac veins (which merge to form the IVC), the renal veins, or even within the portal system itself (portal vein thrombosis).
• Causes: Similar risk factors to DVT elsewhere – prolonged immobility, surgery, trauma, inherited clotting disorders (thrombophilia), cancer, inflammatory conditions, pregnancy, or compression of the veins. For portal vein thrombosis, underlying liver disease is a common factor.
• Symptoms: Symptoms depend on which vein is affected.
• IVC/Iliac Vein Thrombosis: Can cause significant swelling in the legs and pelvis, pain, and skin changes. There's also a risk of the clot breaking off and travelling to the lungs (pulmonary embolism), which is a medical emergency.
• Renal Vein Thrombosis: Can cause flank pain, blood in the urine, and potentially kidney damage or failure.
• Portal Vein Thrombosis: Can sometimes be asymptomatic, but often causes sudden onset of severe abdominal pain, nausea, vomiting, and can lead to or worsen portal hypertension.

Treatment typically involves anticoagulant medication to prevent the clot from growing and to reduce the risk of pulmonary embolism, ¹ and sometimes procedures to remove the clot or open the blocked vessel.  

 

Abdominal Varicose Veins

When most people think of varicose veins, they picture the swollen, twisted veins on the legs. However, varicose veins can also occur internally in the abdomen. These are often related to portal hypertension (as oesophageal, gastric, or anorectal varices) or can sometimes be related to blockages or pressure on other abdominal veins. They aren't typically the superficial, cosmetic issue of leg varices; they are usually a sign of an underlying circulatory problem within the abdomen and carry the risks of bleeding or impaired drainage.

Compression Syndromes

Sometimes, an abdominal vein can be compressed by nearby anatomical structures (like arteries, ligaments, or tumours).

• Examples:
• Nutcracker Syndrome: As mentioned earlier, the left renal vein can be compressed between the superior mesenteric artery and the aorta, impairing blood flow and potentially causing blood in the urine, flank pain, or pelvic congestion in women.
• May-Thurner Syndrome: This usually affects the left common iliac vein in the pelvis, where it is compressed by the overlying right common iliac artery. While primarily pelvic, it affects the major outflow vein leading to the IVC and can cause leg swelling and increased risk of DVT.
• Superior Mesenteric Artery (SMA) Syndrome: While primarily affecting the duodenum (part of the small intestine), the SMA can also compress the left renal vein and, less commonly, the IVC.

These syndromes can lead to pain, swelling, and an increased risk of thrombosis in the compressed vein.

Aneurysms (Aortic)

While aneurysms are dilations or bulges in arteries, not veins, it's worth a brief mention of the abdominal aorta. The abdominal aorta runs parallel to the IVC, and an abdominal aortic aneurysm (AAA) is a potentially life-threatening condition where the wall of the aorta weakens and bulges. While distinct from venous problems, issues with major abdominal vessels highlight the critical nature of the entire vascular network in this area.

Recognising Potential Problems: When to Seek Help

Understanding the potential issues with abdominal veins isn't meant to cause alarm, but rather to empower you with knowledge. Many abdominal symptoms are common and usually due to less serious issues like indigestion or trapped wind. However, being aware of the potential signs of underlying vascular problems is important, especially if you have risk factors (like liver disease, a history of clots, or a family history of clotting disorders).

Symptoms that could potentially be related to problems with abdominal veins include:

• Abdominal Pain: Can vary from dull ache to severe, sudden pain, depending on the cause (e.g., clot, congestion).
• Abdominal Swelling or Distension: Can be due to ascites (fluid build-up from portal hypertension) or swelling of organs due to venous congestion.
• Swelling in the Legs or Pelvis: Particularly if in one leg, could indicate DVT in the iliac veins or IVC.
• Nausea and Vomiting: Can be associated with acute abdominal pain or issues like portal vein thrombosis.
• Changes in Bowel Habits: Less specific, but can sometimes be associated with abdominal issues.
• Jaundice (Yellowing of skin and eyes): Often a sign of underlying liver disease, which is a major cause of portal hypertension.
• Unexplained Weight Loss or Gain: Can be associated with underlying serious illness affecting the abdominal organs and their blood supply/drainage.
• Visible Engorged Veins on the Abdomen (Caput Medusae): A specific sign of severe portal hypertension.
• Vomiting Blood or Passing Black, Tarry Stools: Urgent medical emergency, potentially indicating bleeding from oesophageal or gastric varices due to portal hypertension.

IMPORTANT DISCLAIMER: Please, please, please remember that this information is for general knowledge only. These symptoms can be caused by a vast number of conditions, most of which are not related to serious abdominal vein problems. If you experience any persistent, severe, or worrying abdominal symptoms, it is absolutely crucial to see a doctor. Self-diagnosis based on internet information is unreliable and potentially dangerous. A healthcare professional is the only one who can properly evaluate your symptoms, consider your medical history, and order the appropriate tests to determine the cause and recommend the correct treatment.

How Are Abdominal Veins Studied? (Diagnosis)

When a doctor suspects an issue with your abdominal veins, they have several tools at their disposal to investigate:

• Medical History and Physical Examination: Always the first step. The doctor will ask about your symptoms, medical history, lifestyle, and perform a physical exam, feeling your abdomen for swelling or tenderness.
• Blood Tests: Can provide clues about liver function, kidney function, clotting factors, and overall health that might indicate an underlying issue affecting the veins.
• Imaging Techniques: These are essential for visualising the abdominal veins:
• Ultrasound (Duplex Ultrasound): Often the first imaging test. It uses sound waves to create images of the organs and blood vessels and can assess blood flow direction and speed, helping detect blockages or abnormal flow in veins like the portal vein or IVC.
• CT Scan (Computed Tomography Angiography/Venography): Uses X-rays and a contrast dye injected into a vein to create detailed cross-sectional images. CT venography can provide excellent views of the abdominal veins and detect clots, compressions, or abnormal vessels.
• MRI (Magnetic Resonance Imaging Angiography/Venography): Uses magnetic fields and radio waves to create detailed images. MRI venography can also clearly show abdominal veins and surrounding structures without using ionising radiation (X-rays).
• Venography: A more invasive procedure where a catheter is inserted into a vein (usually in the groin) and threaded into the abdominal veins. Contrast dye is injected, and X-ray images are taken as the dye flows through the veins. This provides very detailed images of the venous structure and can be used to measure pressures or perform interventions.
• Endoscopy: For suspected oesophageal or gastric varices, an endoscopy (inserting a flexible tube with a camera down the gullet and into the stomach) is used to visualise the lining and the veins directly.

Based on these investigations, a diagnosis can be made, and an appropriate management plan can be developed.

Looking After Your Abdominal Circulation (General Well-being)

While you can't directly 'exercise' your abdominal veins like you can skeletal muscles, maintaining overall circulatory health and addressing underlying conditions is the best way to look after this vital network:

• Healthy Lifestyle: A balanced diet, regular physical activity, maintaining a healthy weight, and avoiding smoking are beneficial for your entire cardiovascular system, including your abdominal veins.
• Manage Underlying Conditions: If you have conditions like liver disease, heart disease, kidney disease, or clotting disorders, working closely with your doctor to manage them is crucial, as these can significantly impact abdominal venous health.
• Stay Hydrated: Adequate hydration helps maintain blood volume and fluidity, supporting healthy circulation.
• Avoid Prolonged Immobility: While less directly impactful on deep abdominal veins than leg veins, general circulation benefits from avoiding long periods of sitting or standing. If you must be still for extended periods (e.g., long flights), consider calf exercises and staying hydrated.
• Moderate Alcohol Consumption: Excessive alcohol is a major cause of liver cirrhosis, which leads to portal hypertension. Limiting alcohol intake is vital for liver health and, consequently, portal venous health.

These are general well-being tips; always follow the specific medical advice given by your doctor regarding any diagnosed health conditions.

The Human Element: Acknowledging Complexity and Wonder

Stepping back from the detailed anatomy and potential problems, it's worth taking a moment to simply appreciate the sheer marvel of the human body. The abdominal venous system, with its unique portal detour, is a brilliant piece of biological engineering. It's a system that perfectly integrates the functions of digestion, metabolism, detoxification, and circulation.

Thinking about the hundreds of miles of blood vessels, from the smallest capillaries collecting blood from individual cells in your gut lining, to the massive IVC channeling blood back to your heart, all working in concert every second of every day – it’s truly breathtaking.

We often take these internal workings for granted until something goes wrong. But even a basic understanding can foster a deeper appreciation for the intricate, tireless processes happening beneath the surface. It underscores the interconnectedness of our organs and systems – how a healthy liver is essential for healthy portal veins, and how efficient venous drainage is crucial for every abdominal organ to function correctly.

So, the next time you feel a little rumble in your tummy, or simply pause for a moment of reflection, remember the incredible, complex, and vital network of veins silently working away inside you, keeping the show on the road. It’s a hidden world, but one that’s fundamental to your health and vitality.

In Conclusion: The Abdomen - Vein Central

To circle back to our original question, "Are there veins in the abdomen?" The answer is a resounding, unequivocal YES. Not only are there veins, but they form one of the most functionally unique and anatomically complex venous networks in the entire body.

From the colossal Inferior Vena Cava draining the lower body and many abdominal organs directly towards the heart, to the extraordinary Hepatic Portal System that reroutes blood from the digestive tract and spleen through the liver for essential processing – these vessels are indispensable.

They are the unsung heroes collecting waste, transporting processed nutrients, and playing a critical role in detoxification. While out of sight, their healthy function is paramount for the proper working of your digestive system, liver, kidneys, and indeed, your entire body.

Understanding this hidden network, even in a general sense, gives us a deeper appreciation for the incredible complexity and resilience of human anatomy. And perhaps, it serves as a gentle nudge to look after the body we inhabit, supporting these vital internal systems through healthy choices and seeking medical attention when needed.

So there you have it – a comprehensive peek into the world of abdominal veins. It's a subject that demonstrates beautifully just how intricately and intelligently the human body is designed. Keep well, and perhaps spare a thought for that amazing plumbing keeping everything shipshape down in your tummy!

 

Keywords: Abdominal Veins, Veins in the Abdomen, Abdominal Circulatory System, Inferior Vena Cava, Portal Vein Anatomy

Hashtags: #AbdominalVeins #HumanAnatomy #CirculatorySystem #HealthFacts #BritishHealth.