Gas, reflux and chest pain: what to know

Reflux happens when stomach contents move upward into the oesophagus, causing burning behind the breastbone, a sour taste, belching or symptoms after meals and when lying down. Gas can add fullness or pressure and may improve after burping or passing wind. Gastritis and peptic ulcer can cause upper-abdominal discomfort near the lower chest. Angina may feel like pressure or tightness during exertion. Pneumonia can cause pain with cough or fever, while pulmonary embolism may cause sudden chest pain and breathlessness. Panic disorder can produce chest symptoms too, but a diagnosis should not be assumed from anxiety alone.

Eat slowly, choose smaller meals and remain upright after eating. Reduce fizzy drinks and any foods that repeatedly trigger burning or bloating. Avoid strenuous activity while chest discomfort is present. A pharmacist can advise about an antacid or acid-reflux medicine, taking account of pregnancy, kidney problems and other medicines. Improvement after an antacid does not rule out a heart or lung problem, so keep track of timing, triggers, duration and accompanying symptoms.

Call emergency services for persistent or severe chest pain, pressure spreading to the arm, jaw, back or shoulder, or pain with breathlessness, sweating, nausea, faintness or a racing heartbeat. Coughing blood, blue lips, sudden weakness or chest pain after prolonged immobility or recent surgery are also emergency signs. Arrange a medical review for frequent reflux, trouble swallowing, repeated vomiting, black stools or symptoms that disturb sleep.

Does the pattern suggest reflux, or should my heart and lungs be checked? Which medicines could worsen reflux? Would a treatment trial be appropriate? What symptoms require emergency help rather than a routine appointment?