Q: I have a question regarding burning sensation in my stomach. I am 60 years old and have asthma, emphasyma and an ulcer. I smoke a pack of cigarettes a day. When I wake up, I have severe headache and can hardly breathe. I use my asthma machine about thrice a day and my inhaler a lot. My stomach is always burning especially in the mornings. What can this be? Can my headaches be because I am not getting enough oxygen or because of my stomach? When my stomach starts acting up I get a very bad headache. My doctor has not been of great help to me, so I can really use a second opinion. I also bleed a lot from my rectum. Mainly when my stomach is having a bad day. Can you give me your opinion please? I can't sleep at night because of this pain. It's so bad that my whole body aches in the mornings.

A:From the gastroenterology point of view I think that you suffer with dyspepsia which may be reflux related (and would also explain your asthma) or ulcer related. A firm diagnosis is difficult to make in the absence of an endoscopy, and this is what I would suggest for you before starting any treatment. The headaches are probably due to lack of oxygen and increased levels of carbon dioxide in your blood, related to your breathing problem. With regard to the rectal bleeding, this needs more urgent attention, with a consultation with a gastroenterologist, who will put you up for a check of your lower bowel using a proctosigmoidoscope or a colonoscope. It may all be due to haemorrhoids, which can easily be treated by a general surgeon, but given your age of 60, we do need to make sure that we are not missing anything else. Hope this answers most of your queries.