Dr Bernadette Carr answers your questions on heartburn and nail cutting

My husband is in his 50s and over the last couple of months he has had heartburn and acid reflux on a number of occasions after eating.

He is reluctant to visit his GP, but as he is a little overweight I think he should have this checked out.

This must be very uncomfortable for your husband and I would certainly advise him to visit his GP.

The cells in the lining of the stomach produce acid and other chemicals which help us to digest our food.

There is a band of muscle between the stomach and oesophagus which relaxes to allow food down and tightens up to prevent food or acid leaking back up (reflux) into the oesophagus.

Heartburn is one of the most common symptoms of acid reflux particularly in those aged 35-64 years, characterised by burning sensation over the centre of the chest and rising toward the neck and usually is worse 15- 60 minutes after a meal.

It may be accompanied by reflux of acid in the mouth and precipitated by bending or lying flat. Heartburn is common in those who are overweight.

Most people will have heartburn at some point in their lives. In many cases it is mild and very soon passes.

Here are some suggestions to ease reflux symptoms before your husband sees his GP:

* If he is a smoker, stop smoking

* Reduce alcohol intake

* It is important to maintain an ideal weight

* Some food and drink may trigger the pain, so cut down on spicy foods, hot drinks, alcohol and any other trigger-foods that you can identify

* Try to avoid bending forward as this might encourage the reflux.

* Eat small regular meals, avoiding big meals and long period of fasting

* If he notices it happening when he lies down try to avoid eating or drinking for two to three hours before going to bed

* Regular exercise.

It is important to have the cause of these symptoms investigated. Once a diagnosis has been made I am sure that his GP will be able to advise as to how best to manage this, if a weight-reduction programme is necessary, or if any further treatment or investigations are needed.

Recently, the toenail on one of my big toes has been really painful and the skin beside the nail is red. I have a habit of cutting my toenails very short, could this be an ingrown toenail?

Pain in the toenails can be very uncomfortable as I am sure you have found. Ingrown toenails (onchyocryptosis) are very common, particularly in the big toe and may affect one or both sides of the nail.

This is when the nail burrows into the nail grove. The nail groove ulcerates and its wall grows over the nail. Females and males are affected equall, especially young men and elderly women.

They occur when the side of the nail cuts into the skin bedside the nail and sometimes this skin can get infected, becoming red and swollen. Cutting the toenails very short is a common cause of ingrown toenails as is wearing tight fitting shoes or socks.

Other causes include an injury to the toenail or a fungal nail infection such athlete’s foot.

As the skin beside your toenail is red, you need to make an appointment with your GP who can examine the nail and make a diagnosis. To prevent an ingrown toenail here are some general suggestions for you to consider.

* Toenails should be cut straight across, do not cut too short or cut in at the sides

* Avoid wearing shoes, socks or tights that are too tight; they put pressure on the nails

* Wear comfortable shoes that fit properly and have space around the toes without being too loose

* Practice good foot hygiene, wash your feet regularly and dry them thoroughly

* Have a regular appointment with a chiropodist or podiatrist so that potential problems can be identified early on

* When you are at home, try going about with bare feet to keep pressure off the toes

I am sure your GP will be able to reassure you and advise on the appropriate management.