A Word with the DOCTOR
by Dr John Winsor
The Sunday Times of Malta

"I KEEP getting chest pains, doctor!" is a common enough complaint from my patients.

The pain they are most worried about is the one that strikes them in the centre of the chest underneath the breastbone because they think they are having a heart attack.

The good news is that it is usually heartburn, which has nothing to do with the heart itself. It is a special type of indigestion where acid from the stomach is regurgitated upwards into the food pipe or oesophagus.

The environment in the oesophagus is alkaline, so the excess acid burns the lining. As this tube shares some of the same nerves as the heart, pain is often 'referred' to the area around the heart - hence the name and the fear that it is more serious than indigestion.

Without a doctor to advise you, it is very difficult to tell which is a heart pain and which is heartburn.

The symptoms of heartburn are a pain or burning sensation behind the breastbone. This may or may not be associated with regurgitation of food or liquid into the back of the throat or mouth. The fluid may be acid to the taste or watery and regurgitation is more likely to occur when you bend down.

The most common cause of this is a weak muscle at the junction of the gullet and stomach - normally, this muscle stops the reflux of acid from the stomach. For overweight people, the act of bending down squeezes the stomach and excess fat around the stomach, forcing food and acid in the wrong direction.

If you want to prevent heartburn -then don't smoke or drink alcohol - they are both irritants and tend to increase the amount of acid your stomach produces - and don't eat late at night, or you'll go to bed and lie flat with a distended stomach that's busy making acid to digest the food.

Very fatty, spicy or cold foods may well make matters worse. Avoid coffee, cucumbers, onions or anything else which you find brings on heartburn and don't wear tight belts or clothes, which will squeeze you just in the right place to bring on the symptoms of heartburn.

Do eat smaller- meals and try to lose a few pounds if you are overweight. Also, take care when you bend down - if you keep your back straight, you won't squash the contents up and out of your stomach.