EVERYONE experiences acid reflux from time to time. But when is it a sign of something sinister?

You’re more likely to feel that burning feeling in the chest after eating spicy foods, fatty meals, alcohol, caffeine and citrus fruits.

Usually, cutting down on these things is a GP’s initial advice. Other measures include keeping a healthy weight, deep breathing, quitting smoking, and sleeping on your left side or using cushions to elevate your upper body.

If acid reflux occurs more than twice a week, it may be gastro-oesophageal reflux disease.

You might experience belching, feel bloated or sick, have a bad taste in your mouth or smelly breath.

Ask your pharmacist about antacids that may give relief from symptoms. But a prescription medication, such as proton pump inhibitors or H2-receptor blockers, may be needed for persistent symptoms.

See your GP for new symptoms such as difficulty swallowing, unexplained weight loss, chest pain, or vomiting blood.

Here’s a selection of what readers have asked me this week.

WORRIED MY KIDNEYS WILL GET WORSE

Q: I HAVE been diagnosed with stage 3 chronic kidney disease.

This came to light at my annual review when I had blood and urine tests carried out.

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All I was told was that I have had it for some time – about two to three years.

I have had no consultations but feel I need more information, including what I can expect in the future.

I need to know how likely it is that it gets to stage 4 or 5 and what the outcome would be regarding dialysis or a transplant.

I am a 74-year-old woman and still work part-time.

A: A diagnosis of chronic kidney disease can be alarming.

It means your kidneys do not work as well as they should.

Some people incorrectly assume that the word “chronic” means it is severe – this is not the case. It simply means it’s a long-term condition.

Stage 3 CKD means that the damage to the kidneys is mild to moderate.

According to research, approximately half of individuals with CKD stage 3 will eventually progress to stage 4 or 5 over a significant period, like ten years.

CKD becomes more likely as we get older and in people who have certain conditions such as high blood pressure and diabetes.

Kidney infections, high cholesterol and long-term uses of non-steroidal anti-inflammatory drugs (such as ibuprofen) can also increase the risk over time.

If your CKD is stable over the next two to three years, this will be a good sign, and the aim will be to keep it so as long as possible.

Only a small proportion of people progress to kidney failure – which is a serious condition, that may require dialysis.

CKD can get worse over time so it’s important to monitor it and manage it, with lifestyle measures and medication.

You can support your kidney health by quitting smoking, eating healthily and staying physically active as well as managing any blood pressure issues or diabetes.

Tingling pain in feet is unbearable

Q: FOR several weeks I have had severe pain caused by tingling of the toes on both feet.

This only happens when I either sit or lay down. The tingling starts immediately upon sitting and the pain feels unbearable.

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My GP has prescribed amitriptyline tablets, which only help me to sleep. I have had blood tests also, which do not imply the cause of this.

Could this be due to nerve damage in my back as it appears to be posture-related? I am awaiting an MRI scan.

A: Yes, it could be due to pressure being put on a nerve when you are sitting and lying down, which is alleviated by repositioning into a standing position.

Sciatica can present this way in some people.

It’s caused by pressure or irritation to the sciatic nerve in the lower back.

This can have several causes including a herniated disc or spinal stenosis.

While the issue is in the lower back, the sciatica can be felt anywhere along the sciatic nerve, which travels down the back of the leg all the way to the foot.

Most cases of sciatica get better over a few weeks, but if it’s been going on for more than six weeks, it’s worth seeing your GP. Your GP can also check that you have a good arterial blood supply to the feet.

If blood supply is poor (peripheral arterial disease) this could be exacerbating a nerve issue or could be causing the problem in its own right.

Patients with poor arterial circulation to the lower limbs typically describe painful aching in the legs when walking upstairs or uphill, which is alleviated by a few minutes of rest.

But other symptoms can include numbness or weakness, paler shiny skin with loss of hair, muscle wasting of the legs and skin ulcers.

Position can affect symptoms in more severe peripheral arterial disease, which can occur at night-time, when tingling in your foot or toes may wake you up.

Standing up, or hanging your legs over the side of your bed can alleviate symptoms as it helps increase the blood flow to the feet.

So while sciatica is the likely issue, it’s important to consider circulation if these symptoms resonate.