Category: MIL-OSI

Source: The Conversation – UK – By Dai O’Brien, Associate Professor, BSL and Deaf Studies, York St John University

Deaf is a deeply emotional examination of what having a baby can mean for a mixed deaf and hearing couple. Spanish director Eva Libertad’s film explores where access, language and trying to keep a family together under the extreme pressure of new parenthood and social expectations come to a point.

Throughout the film, there is a clear divide in deaf and hearing spaces, and clear differences in how people are treated in each one. A key element of this is the thoughtful effort to facilitate communication by adapting to people’s different abilities.

At home, Ángela (played by deaf actor Miriam Garlo) and her partner Héctor (Álvaro Cervantes) communicate easily and comfortably in a mixture of sign and speech. Ángela’s experience in work is similar. While her work colleagues don’t sign fluently, they obviously value her and care about her and put effort into their communication and relationships. This care is reflected in the baby mobile they give Ángela, which has carefully moulded hands in different configurations so that Ángela’s language is represented in her baby’s toys.

Ángela is made to feel safe and valued at home and work thanks to the care and respect everyone shows to each other when communicating, whether in speech, sign or a mixture of both. The same is true of the deaf communities in which she and Héctor are involved – Héctor is embraced, teased, accepted and treated as an equal. But when their relationship encounters the hearing world, this all changes.

Despite Héctor’s efforts to help Ángela communicate with healthcare staff, the indifferent medical system and emotional strain take their toll on him.

The issue comes to a head when the gynaecologist demands that he stops interpreting and moves out of Ángela’s line of sight while Ángela is giving birth. This leaves her alone, scared and with her hands restrained by anonymous medical professionals whom she can’t understand.

This deeply traumatic experience of giving birth is something that is very common for deaf women, which makes it extremely uncomfortable to watch on screen. It’s an impossible decision that is forced on Héctor: does he insist on staying when the full power of the medical institution is drawn against him, possibly putting Ángela in further danger? Or does he acquiesce and leave his partner alone during this horribly traumatic ordeal?

It’s a choice that colours their relationship. It is also a taste of what is to come. Together, they will have to make similarly impossible compromises, which are forced upon them by the discriminatory institutions and attitudes that surround them and their own emotions and beliefs.

The separation of the environments in which Ángela feels able to exist as a mother becomes increasingly stark as the film progresses. Her lack of access to speech and the lack of accommodations offered to her are cruelly highlighted in several of the interactions she has with hearing people, resulting in her growing alienation and isolation from the other parents in her daughter Una’s nursery.

The speech- and hearing-centred expectations of the parent group and the nursery itself make her feel unable to be a competent mother in that environment. She is unable to join in with the simplest games and activities the nursery leader does with Una and the other children, as they are all based around sound.

While she is still embraced as herself by the deaf community, she finds it difficult to be a mother in those settings as well. She finds it difficult to integrate the compromises she is having to make at home with who she sees herself to be, and this is affecting every part of her life.

In their home, where previously Ángela and Héctor were able to build a haven of communication based on equality, the invasion of Ángela’s parents and Héctor’s friends, none of whom sign well, unbalances the status quo they have carefully constructed. This disrupts the linguistic care work they each do for the other to the point that their relationship creaks under the strain.

This film isn’t just about being deaf, although that is a huge part of Ángela’s life, and the heartbeat of the film. It will also resonate with those who have multilingual families. It highlights the compromises, the guilt, the heartbreak and the joy that raising kids in multilingual and multicultural contexts can bring, and the huge amount of emotional work that goes with that. It’s an important film, one that takes authenticity and representation seriously, and is one that anybody who works with deaf people at any stage of pregnancy and parenthood should watch.

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Dai O’Brien does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Deaf: a powerful film about the real struggles of deaf families navigating medical institutions and parenthood – https://theconversation.com/deaf-a-powerful-film-about-the-real-struggles-of-deaf-families-navigating-medical-institutions-and-parenthood-265013

Source: The Conversation – UK – By Renaud Foucart, Senior Lecturer in Economics, Lancaster University Management School, Lancaster University

Before resigning from his nine-month stint as French prime minister, François Bayrou had claimed that if France failed to cut its public deficit, young people would pay the price “for the sake of the comfort of boomers”.

This blunt assessment cut to the heart of France’s current economic reality. For behind the country’s growing budget deficit lies a story of generational unfairness. And those who created the problem are unlikely to pay for its solution.

The crux of that problem is that for decades now, the French government has spent much more than it earns. At the moment, it is borrowing around 6% of GDP a year. Over time, these borrowings have added up, so total public debt now stands at €3.3 trillion (£2.8 trillion), equivalent to 114% of GDP.

By contrast, the UK’s public debt is around 101% of GDP, and the EU average is 81%. (There are extreme cases like Japan, where the figure is 250%.)

As Bayrou made clear, the French deficit is mostly a boomer problem, as it has subsidised privileges for a very lucky generation. People born in the 1950s generally paid just a small proportion of their salaries to finance generous pensions, and voted to lower the pension age.

Spending on public pensions now makes up a quarter of France’s budget, with the average payment around €1,500 per month (£1,300, compared to around £1,000 in the UK). But 1.7% of French pensioners receive more than €4,500 per month, and a former senior executive could be receiving over €100,000 every year from the government.

This means that while public pensions in the UK cost around 5% of GDP, in France it is almost 14%. An early retirement age and longer life expectancy means that a French worker retiring now can expect to enjoy around 25 years of retirement, compared to 21 in the UK, or 20 in the US.

The economic impact of this situation is profound. On average, people currently retired in France end up with a pension pot containing double their own contribution – much more than future generations can hope to receive.

So on the whole, today’s French pensioners are doing pretty well.

For the time being the debt remains manageable. France currently borrows at a much cheaper rate than the 12% Portugal or Ireland had to pay during the eurozone crisis.

The trouble is that new debts racked up by France are becoming more expensive. As rating agencies re-evaluate French debt the cost is likely to increase further.

And like the proverbial frog in gradually boiling water, France may not realise that its ability to sustain its public finance is changing until it’s too late.

France v UK

The situation is different from the economic challenges facing the UK, which is experiencing increasing costs to finance its own debt, and is much more reliant than France on international investment.

France tends not to depend on investment and loans from the rest of the world as the UK does, and is able to borrow from French savers and the European Central Bank. It is also part of the eurozone, where that same bank is committed to doing “whatever it takes” to preserve the euro. This effectively protects member countries from foreign investors betting on their bankruptcy.

But just because France’s debts are different does not mean they do not to have to be managed. To be sustainable, public debt cannot be allowed to keep on rising as a share of GDP.

If it does, simply paying the interest of the debt becomes unaffordable. To avoid defaulting, France would then need to ask the help of the European Central Bank, and accept reforms imposed by other European countries, just like Greece and the Republic of Ireland had to cut benefits and raise taxes in exchange for bailouts during the Eurozone debt crisis.

And ultimately, there will be no solution to France’s financial problems without talking about – and changing – pensions. The current generational unfairness is so stark that subsequent governments use complex accounting tricks to try to deal with it.

Almost 10% of the schools budget, for example, is diverted to fill the gaps in the entire public sector pension system. But these kinds of loopholes will not be enough in the long term.

Eventually, freezing or lowering pensions and moving to a cheaper system will be unavoidable. Bayrou’s government fell as it tried to do this. It failed to build the necessary coalitions to govern such a divided country. But it may end up succeeding in delivering a message.

And that message is that France’s fiscal future depends on confronting the privileges of those who created the problem. The question is not whether this reckoning will come, but whether it arrives through political choice or economic necessity. The latter would be much more damaging for the younger generations of France.

Renaud Foucart does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. The French economy has a boomer problem and is spending way too much on pensions – https://theconversation.com/the-french-economy-has-a-boomer-problem-and-is-spending-way-too-much-on-pensions-264912

Source: The Conversation – UK – By Christopher Gaffney, Senior Lecturer in Integrative Physiology, Lancaster University

Running has a huge number of benefits. The popular workout can prevent disease, improve mental health and even slow the biological ageing process.

But around 31% of us aren’t regularly doing enough physical activity – including going for a run. The most commonly cited barrier to exercise is a lack of time.

But what if all the benefits of running could be had but in a fraction of the time? This is where interval running comes in.

Interval running is a form of high-intensity interval training (HIIT). HIIT has been around for almost a century, but gained popularity throughout the 90s and 2000s thanks to workouts such as Tabata (20 seconds of intense exercise, ten seconds of rest) and CrossFit (a high-intensity workout that combines weightlifting, gymnastics and cardio).

The key aspect of HIIT is alternating between bursts of highly intense exercise followed by periods of rest or low-intensity exercise. For instance, during a regular HIIT workout you might perform 30 seconds of burpees at your maximum effort, before resting for 30 seconds. The move is then be repeated a few times.

HIIT principles can also easily be applied to your regular runs if you’re looking to reap the benefits of this workout but in a shorter time-frame.

For instance, with the “10-20-30 method”, runners start with 30 seconds of jogging or walking, followed by 20 seconds of running at a moderate pace – then finishing with a ten second sprint.

Or, the “fartlek” method (Swedish for “speed play”) is another easy way to get into interval running. This involves mixing in a few sprints during your jog instead of just keeping a steady pace.

The benefits of intervals

Interval running HIIT workouts can have numerous benefits – including for your cardiovascular system, your metabolism and your body composition (how much fat you have and where it’s stored).

For instance, research has shown that in overweight and obese people, sprints provided even greater gains in a specific aspect of cardiovascular fitness when compared with those who did a regular, steady pace run. The participants who performed sprints saw greater improvements in their V̇O₂ max – the amount of oxygen the body is able to use to fuel intense exercise.

In those who already run regularly, a 12-week trial found that adding HIIT workouts to a weekly endurance run for 12 weeks improved V̇O₂ peak to a greater extent than when they did longer continuous runs. V̇O₂ peak is a measure of cardiovascular fitness which shows your cardiovascular capacity. A bigger V̇O₂ peak is helpful for performance and also reduces the risk of death from any cause.

Research has also shown that interval walking and running has a more potent effect on your metabolic health – specifically the regulation of blood glucose levels, which can help lower risk of type 2 diabetes – than a continuous walk does.

HIIT workouts such as the 10-20-30 method have a greater effect on the energy-producing parts of our cells (known as the mitochondria) than continuous exercise. This means greater stamina and lower risk of diabetes and cardiovascular disease. The 10-20-30 method also has the benefit of reducing our “bad cholesterol” and blood pressure more than continuous running does. This means reduced risk of cardiovascular disease.

Finally, while both continuous running and HIIT can reduce visceral fat levels – the dangerous fat stored around our organs – HIIT can do this in a more time-efficient way.

In each of these instances, the benefits are accrued in a fraction of the time it would take with a conventional run. As little as 18 minutes of sprint interval runs three times a week can lead to health benefits.

How to get started

If you’re keen to give interval running a try, there are a few different ways you can get started.

If you normally run outdoors, you can try sprinting from one lamp post to the next – then recovering by walking or jogging to the next lamppost before sprinting again. This is a form of fartlek training.

In a gym setting, this can be done using both a non-motorised treadmill or a traditional motorised treadmill. The latter usually has interval training programmes that you can select – allowing for sprints then recovery. This can also be done with walking.

Sprints can be completed for just a few seconds to a couple of minutes. The key with interval running is to get your heart rate towards 90% of your maximum during the “intense” part to get the most benefits. Ensure you recover sufficiently between sprints.

Like with any exercise programme, it’s important to build up your activity levels over time.

If you’ve been sedentary for a few years, jumping immediately into interval running probably isn’t a good idea.

It’s also sensible to consult with your GP before starting new exercise regimes, particularly if you have any medical conditions. For instance, HIIT can actually increase blood sugar levels, resulting in hyperglycaemia in those with diabetes, so they should definitely speak to their doctor before giving this a try.

A good rule of thumb is try adding in a few sprints during your next run – be that for a few seconds to a minute. In two to three months, you’ll probably start to see the benefits.

Or, if you don’t care to try sprints, you could do the “10-20-30” method during your runs, or try “Jeffing” (the run a bit, walk a bit method).

Increasing the intensity even just a little bit occasionally during your runs can lead to numerous benefits for your health and fitness.

Christopher Gaffney receives funding from UKRI, NIHR, North West Cancer Research, and the Ministry of Defence.

– ref. How adding sprints to your usual jogs can boost the health benefits of running – https://theconversation.com/how-adding-sprints-to-your-usual-jogs-can-boost-the-health-benefits-of-running-263745

Source: The Conversation – UK – By Ruth Emily Sylvester, Research Fellow in Water and Health Governance, University of Leeds

The raw sewage in England’s rivers and seas is not just a story of corporate failure. It’s also a legacy of Victorian sewers – impressive and high-tech in their day, but with inequality and exploitation baked in.

In the summer of 1858, London succumbed to a “Great Stink” as hot weather exacerbated the smell of human waste in and around the River Thames. Along parts of the Thames, sewage was piled six foot deep.

This compelled the Victorians to find a new way of handling the faeces of the world’s largest city. The new Houses of Parliament rushed through legislation and soon commissioned the engineer Joseph Bazalgette to design and build a new sewer system.

Bazalgette’s design was hailed as visionary: a modern network that collected household waste and pumped it to centralised containment points. The shift away from informal sanitation to a formalised system was the bedrock of a public health revolution.

But the system was also a product of its time, and some people and environments benefited more than others. It prioritised the wealthy, and dumped the consequences downstream.

This Victorian legacy infrastructure forms the blueprint of the sewage crisis of the 2020s, in London and across the country. Sewers (often literally the same sewers with the same 150-year-old bricks) still spill untreated waste into rivers when it rains. And, just as in the 19th century, the costs are carried disproportionately by the poor and the environment.

New infrastructure required

Between 1800 and 1850, a third of the population in England moved into urban industrial centres, a shift that ushered in a new era of public health risks from faecal-oral diseases such as cholera. Sustaining this industrial and social revolution required new infrastructure. But sewers built in London and elsewhere were a response to, and a reproduction of, the social arrangements of the industrial period.

Their core design values were to protect the health of the labouring workforce and to secure the lifestyle of wealthy people. Rich neighbourhoods were the first to receive sewer connections, and the business of sewer building became a lucrative investment for the upper classes.

The pipes themselves were designed to both drain rainwater and transport sewage. During periods of heavy rainfall, the combined contents would flush out through pressure relief valves – known as combined sewer overflows – into the Thames and its tributaries. In 2024, these same overflows dumped sewage into England’s watercourses for a total of 3.6 million hours.

Initially, treatment works at Beckton and Crossness were simply discharge points that continued to release raw sewage into the Thames, only further downstream and at the ebb of the tide, blighting many working-class residents of east London.

My research with Anna Mdee and Paul Hutchings found that this also applies elsewhere in England. For instance by the mid-19th century, the city of Bradford became known as “the wool capital of the world”. Yet the Bradford Beck, the river at this city’s heart, was a hotbed of sewage and disease, even after sewers were built in the 1860s. Working class communities living close to its banks were most affected. Tragically, at this time, only 30% of children born to mill workers lived beyond the age of 15.

It was not until the Princess Alice disaster in 1878, when more than 600 people drowned after a passenger ferry sank in a stretch of the Thames near sewage outlets, that politicians called for a better solution for human waste treatment.

Settling tanks were introduced, which separated the liquid and solid elements of sewage, yet both components were disposed of in rivers or seas via pipes or boats transporting the solids out and dumping in deeper waters.

Left to the market

Progress on connecting households to sewers was very uneven. As industrialisation accelerated in London and across England, local governments became ill equipped to address the emerging complexities of sanitation, and often left it to private companies and the market instead.

In Birmingham, for instance, the town centre and wealthy suburbs were connected to sewers in the 1850s, while working-class neighbourhoods had to wait until the 1870s and 1880s.

By the 1890s, wealthy people enjoyed running water and fully plumbed bathrooms, or water closets, containing raised cisterns with the classic Victorian chain pull. Some houses had multiple WCs including separate facilities in servant quarters. However, many working class and rural households still lacked them well into the mid-20th century.

Profits flow upwards

The way sanitation is financed has always reflected inequality. In the 19th century, wealthy city dwellers got sewers first, while upper-class investors and private companies made money from waste. The same pattern persists today. Under England’s privatised water regime, profits flow upwards – not just to CEOs but now to international investors and shareholders. Thames Water, for instance, has been part-owned in turn by a German energy firm, an Australian investment bank and now a Canadian pensions group.

Since privatisation in 1989, these inequalities have been exacerbated. Water companies are highly profitable, yet rivers are still used to dump sewage.

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Read more:
‘Noisome stinking scum’: how Londoners protested river pollution in the 1600s

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This is why creating a new regulator, as proposed in a recent independent review, or renationalising the sector are not enough: the social hierarchies and environmental exploitation of Victorian England are still ingrained in the pipes themselves.

For centuries, nature was seen as a treatment plant, with rivers, lakes and seas absorbing our faeces. This is no longer acceptable.

Sewers built in the 19th century are failing 21st-century England. Just as Joseph Bazalgette reimagined sanitation for the Victorian era, we need an equally bold vision today – one that stops exploiting both rivers and people.

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Dr Ruth Emily Sylvester has previously received funding from EPSRC for her PhD studies. This article is partly based on findings and outputs from her doctoral research.

– ref. From the Great Stink to the modern sewage scandal: why 19th-century sewers are failing 21st-century England – https://theconversation.com/from-the-great-stink-to-the-modern-sewage-scandal-why-19th-century-sewers-are-failing-21st-century-england-263364

Source: The Conversation – UK – By Louise Gentle, Principal Lecturer in Wildlife Conservation, Nottingham Trent University

Do owls have bogies?

Ravine, aged three, Glasgow

Hi Ravine,

The quick answer is yes, but the interesting thing is why.

Bogies, or boogers as they are known in some countries, are made from nasal mucus – you probably call this snot. Snot is produced by your nose and is really important as it helps to trap dirt, germs and other nasty things. This stops these nasty things from going into your body, causing damage and making you ill. Snot also has antibodies in it – special white blood cells that help your body to fight infections. So, snot is super useful for protecting our bodies.

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Curious Kids is a series by The Conversation that gives children the chance to have their questions about the world answered by experts. If you have a question you’d like an expert to answer, send it to curiouskids@theconversation.com and make sure you include the asker’s first name, age and town or city. We won’t be able to answer every question, but we’ll do our very best.

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Snot is also vital to help us to smell things. The mucus traps tiny scent particles that are then transported to special smell receptors in the nose. These allow us to identify different odours like food, which is especially important to help wild animals survive.

Some animals have an amazing sense of smell, much better than ours. Elephants use theirs to sniff out food and water, detect predators, and even recognise their family. But, when animals have a cold, a lot more snot is produced, and this interrupts the ability to smell things properly.

Bogies are just dried snot that collects in nostrils.

Which animals make snot?

All organisms need to protect themselves, and all have a sense of smell. So, all have some sort of snot. Some animals have huge noses and nostrils, so produce loads of snot – these include cows, horses and rhinos. Some animals have a limited sense of smell – animals such as dolphins and snakes taste smells rather than sniff them.

Some animals even include snot in their diets. The vampire squid feeds on marine snow in the oceans. This is made of snot but also poo and dead things. The vampire squid gathers up the falling bits of snot, then once it has collected enough, it eats it.

The marine iguana is one of the sneeziest animals. They produce lots of snot to help them get rid of the large amount of salt they eat from their favourite food, seaweed.

Bird bogies

Animals that rely on their sense of smell produce more mucus – dogs are expert sniffers and are known for having a wet nose. But most birds don’t have a very good sense of smell. This is because they get most information that they need to survive from other senses such as sight and hearing.

As most owls hunt their prey at night, they tend to rely on their amazing sense of hearing rather than their other senses. This means that they don’t use their sense of smell as much as many other animals. So they don’t need to produce loads of snot, but they still make some, and they still have bogies. Their poor sense of smell might explain why I, and my friends who do conservation studies on owls, have never seen an owl with a bogie. We’re going to look more closely now, though!

There are some bird species that rely on a good sense of smell. Kiwis are flightless birds that live in New Zealand. They have long, thin beaks and an excellent sense of smell, and can sniff out earthworms in the soil.

Turkey vultures are also known for their amazing sense of smell. They can smell food such as carcasses from miles away, finding rotting flesh underneath leaves just as quickly as flesh that is out in the open.

Some seabirds use their noses to produce a map of smells to recognise where they are. This is useful on long migratory journeys across the open ocean where there are no features to help them to navigate.

Like the sneezy marine iguanas, seabirds need to get rid of the salt that builds up in their bodies from the seawater they drink and the salty prey they eat. These birds often look like they have a constantly runny nose, with mucus dripping from their nostrils. But the mucus actually comes from salt glands near their eyes.

All of these birds produce lots of snot to help them to smell.

Which animals pick their bogies?

Scientists found that over 90% of people admit to picking their nose. Teenagers seem to pick their nose an average of four times a day – gross!

Nose picking also happens in primates such as gorillas, chimpanzees and lemurs. Recently, an aye-aye – a creepy-looking animal with a super long middle finger – was filmed picking its nose and eating the bogies.

Only animals with fingers can really pick their bogies. Nobody is quite sure why animals pick bogies, but it might be because when snot dries it can sometimes be uncomfortable and block our noses, so picking is done to help us breathe more easily.

Louise Gentle works for Nottingham Trent University.

– ref. Curious kids: do owls have bogies? – https://theconversation.com/curious-kids-do-owls-have-bogies-264514

Source: The Conversation – UK – By Dan Baumgardt, Senior Lecturer, School of Psychology and Neuroscience, University of Bristol

Every so often, a completely random advert stops me in my tracks and makes me wonder what on earth went on in the room where it was created. For me, that moment came this past weekend, courtesy of a bubblegum-pink, cheerfully surreal advert for Pepto-Bismol.

Pepto-Bismol has been around since 1901, when it was first designed to ease the symptoms of cholera. Over the decades, it’s evolved into the familiar pink liquid we know today, promising to treat nausea, heartburn, indigestion and – as their jingle suggests – diarrhoea-ah!

Absurd advert? Definitely. But effective nonetheless, since it actually got me thinking about Pepto-Bismol for the first time in years. And, to its credit, the advertisers slipped in a piece of genuinely useful advice: that if your symptoms persist, see a doctor. That matters, because ongoing indigestion can be a sign of something more serious.

Understanding the upper gastrointestinal tract

In medicine, the gut is divided into two regions: upper and lower. The upper tract includes the mouth, pharynx, oesophagus (or gullet), stomach and the first section of the small intestine: the duodenum. Symptoms from these areas can point to a range of conditions.

One common cluster is dyspepsia: discomfort or pain often accompanied by bloating, burping, nausea and a feeling of fullness. Most of us will have experienced it at some point.

It can also involve reflux – the sensation of stomach contents coming back up – or waterbrash, a bitter taste from stomach acid hitting the back of the throat. Patients describe these in many ways: heartburn, acid reflux or “food that repeats on you”.

Pharmacies offer a wide range of remedies to treat indigestion. The familiar Pepto-Bismol is just one example. Alginates, such as Gaviscon, are medicines that contain seaweed-derived compounds which form a protective “raft” that floats on top of stomach contents, reducing reflux and preventing irritation of the stomach wall by acid. Chewable tablets like Rennies neutralise stomach acid. Even acid-reducing medications like omeprazole can be purchased over the counter. While these can ease symptoms, they can also delay diagnosis and treatment of potentially serious conditions if relied upon for long periods of time.

What causes indigestion?

After a rich or spicy meal or a stomach bug, some indigestion is expected – and might last a few days. Indigestion can also stem from benign conditions such as a hiatus hernia, where part of the stomach pushes through the diaphragm into the chest, making reflux more likely. This is common: it’s estimated that around a third of people over 50 may have one.

Other risk factors include coffee, alcohol, spicy or fatty foods, large portions, pregnancy, obesity and smoking. Some medications, including antidepressants, ibuprofen, anti-inflammatories and iron tablets, can also trigger symptoms.

However, persistent dyspepsia can sometimes be linked to more serious conditions. Inflammation of the oesophagus, stomach or duodenum has many causes, including infection with Helicobacter pylori a common bacteria that can live in the stomach lining and is a leading cause of ulcers. Antibiotics and omeprazole may be required to treat it. In some cases, this infection can progress to a peptic ulcer, which carries serious risks of bleeding or perforation of the gut.

More worryingly, indigestion can occasionally be a symptom of upper gastrointestinal cancers. In such cases, an endoscopy – a flexible camera that examines the upper gut – may be needed, with alternative tests available for those unable to tolerate the procedure.

Other internal cancers can also cause indigestion among other symptoms, including pancreatic and ovarian cancer. Even cardiac chest pain can mimic indigestion.

Symptoms can vary considerably between different conditions and different patients. This is why it’s important not to self-diagnose, and seek medical advice so a doctor can put the pieces together and make an appropriate plan of action.

When to worry

Guidelines from the National Institute for Health and Care Excellence (NICE) – an independent public body that provides national guidance and advice to improve health and social care in England – recommend urgent investigation with endoscopy for patients with a mass in the abdomen or who experience difficulty swallowing (dysphagia). Unexplained weight loss or upper abdominal pain alongside indigestion are also concerning, especially for patients in their 50s, where the risk of cancer is higher.

Investigation may also be considered for persistent indigestion, or that which doesn’t respond to treatment and in patients with iron-deficiency anaemia or a history of peptic ulcers. Family history is also relevant. Having two first-degree relatives (close family such as parents, siblings or children) with upper gastrointestinal cancer is another risk factor.

Acute gastrointestinal bleeding associated with cancer or an ulcer is an emergency. This can present as vomiting blood – either fresh red or looking like coffee-grounds. Some patients can pass blood mixed in their poo or black, tarry, foul-smelling stools. This “melaena” indicates digested blood. Here, immediate hospital care is essential.

Other warning signs include the presence of jaundice (yellowing of the skin), nausea and vomiting, altered bowel habits and tiredness. And since conditions like ischaemic heart disease (a narrowing of the heart’s blood vessels that can restrict blood flow and cause chest pain) may present like indigestion, vigilance is important for cardiac symptoms, especially in people with risk factors.

While advertising for Pepto-Bismol might spark a smile (or grimace), here’s the reality check: indigestion is common but not always harmless. Over-the-counter treatments can provide relief and many benign conditions often prove to be the underlying cause. But in some cases, persistent symptoms may signal a more serious underlying condition, including cancer.

So, if it’s a recurrent, persistent or severe problem, or you notice other worrying changes, skip a refill at the self-medication aisle. Make an appointment with your GP instead. Sometimes that pink bottle isn’t enough and catching problems early can make all the difference.

Dan Baumgardt does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Indigestion is commonplace but sometimes concerning. Here’s what you need to know – https://theconversation.com/indigestion-is-commonplace-but-sometimes-concerning-heres-what-you-need-to-know-262982