A low blood count or anaemia can lead to tiredness and breathlessness. This is may be due to loss of blood from the gut (especially if there is evidence of low body iron stores)...

Heartburn / reflux

Reflux oesophagitis - ulcers due to reflux
An area of ulceration at the junction between the oesophagus and the stomach
Reflux oesophagitis - ulcers due to reflux

Heartburn is the symptom of “burning discomfort” behind the “breastbone”.

    Heartburn results from acid in the oesophagus.
    • The stomach is designed to handle acid but the oesophagus has a different lining and is more sensitive to the effects of acid.
    • This sensitivity to acid varies significantly from person to person.
  • The basic abnormality is weakness of the valve between the oesophagus and the stomach.
    • This "valve" is designed to allow food into the stomach but to prevent acid and food refluxing back into the oesophagus.
    • Weakness of the valve (sphincter) does not improve over time; in fact - it may tend to weaken further over the years.
    • This “valve” function is adversely affected by a hiatus hernia. A hiatus hernia is when the top part of the stomach is sitting up in the chest instead of being below the diaphragm. This causes the valve to be working at a disadvantage (not as effective for reasons that are not entirely clear).
  • Reflux may be aggravated by
    • fatty foods; spicy foods
    • alcohol
    • smoking
    • chocolate
    • peppermint
    • caffeine
  • Some drugs can aggravate reflux;
    • Asthma treatments.
    • Anti-inflammatory drugs.
    • Calcium channel antagonists - given for high blood pressure.
  • Stress does not cause reflux but can make the symptoms more distressing.

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