Medicines & Safety
Paracetamol: How Much Is Safe, and the Liver Risk
The safe adult maximum is 4 g in 24 hours. Above that it damages the liver, and for the first day or two an overdose causes almost no symptoms at all.
28 Aug 202611 min read
Reflux
Also known as Acid reflux, GORD, GERD, Heartburn
Reflux is stomach acid escaping upward into the food pipe, causing burning behind the breastbone and an acid taste. Occasional reflux is common; when it happens regularly it is treated as a condition in its own right.
A muscular ring at the base of the oesophagus normally stays shut and opens only to let food through. Reflux is that valve relaxing when it should not, allowing acidic stomach contents up into a lining with none of the stomach's protection. The result is the burning known as heartburn, typically worse after a large meal, on bending forward, and on lying flat at night.
Pressure and posture explain most of the pattern. A full stomach, raised abdominal pressure from weight or pregnancy, late meals and lying down all favour it, which is why the first measures are practical: smaller and earlier evening meals, raising the head of the bed, and stopping smoking. An makes matters worse and is best avoided where reflux is troublesome.
Chest pain from reflux and chest pain from the heart can feel alike, and reflux is a diagnosis made after cardiac causes have been considered — not a reason to dismiss new chest pain, particularly on exertion. See .
Where this comes up
Pulmonology
A Cough That Will Not Go: When to Worry and What Causes It
In Pakistan a cough lasting two weeks or more should be tested for tuberculosis. What else causes a long cough, and the signs that mean see a doctor now.
27 Aug 202610 min read
Cardiology
Chest Pain: When to Worry and When to Call for Help
Chest pain lasting more than a few minutes with sweating, breathlessness or pain spreading to the arm or jaw is an emergency. Call Rescue 1122 now.
25 Aug 202611 min read
ENT
Sore Throat: When It Needs an Antibiotic and When It Does Not
Most sore throats are viral and settle in a week without an antibiotic. How to spot the ones that are not, what helps, and why rheumatic fever changes the rules here.
24 Aug 202612 min read
Related terms
- GastritisStomach inflammation, Maiday ki sozishGastritis is inflammation of the stomach lining, causing burning or gnawing pain in the upper abdomen, nausea, bloating and early fullness. The two commonest causes are Helicobacter pylori infection and regular use of painkillers from the NSAID group.
- EndoscopyGastroscopy, Upper GI endoscopyAn endoscopy is an examination of the inside of the body with a thin flexible tube carrying a camera and a light. The commonest kind passes through the mouth to look at the food pipe, stomach and the first part of the small intestine.
- NSAIDNon-steroidal anti-inflammatory drug, Anti-inflammatory painkillerNSAIDs are painkillers that also reduce inflammation and fever — ibuprofen, diclofenac, naproxen and aspirin among them. They work well but carry real risks to the stomach, the kidneys and the heart.
- SymptomA symptom is something a patient notices and reports — pain, nausea, tiredness. It differs from a sign, which is something a doctor can observe or measure.
- BMIBody mass index, Quetelet indexBody mass index is weight in kilograms divided by height in metres squared, used as a rough screen for whether a person carries too much or too little weight for their frame. South Asians face weight-related risk at a lower BMI than the standard chart assumes.