Surely, you tell yourself, surely this belly pain is nothing more than a little indigestion.  After all, you just consumed the greater portion of a large pizza adorned with beacoup pepperonis, followed of course by the mandatory beer and then, just for a little sugar rush, an old fashioned chocolate donut.

Well, if you’re twenty and in reasonable shape that might be the case. However, for those of us who have passed those years and are perhaps not able to run a marathon  other, more serious causes exist.

First and foremost, ask yourself how bad is the pain? Do you have risk factors for heart disease such as previous known heart problems, high blood pressure, high cholesterol, diabetes or family members with heart disease? If so, it would be wise to make a visit to Petaluma Valley Hospital emergency room where we can sort out whether digesting that pizza robbed your heart of some blood leading to angina or even worse a heart attack.  Yes, heart attacks can present simply as indigestion.

Gallbladder attack is another problem which that pepperoni pizza might have caused.  Fatty food (just remember all that delicious melted cheese!) causes the gallbladder to work overtime trying to process the mountain of fat coming down the turnpike.

People who have hardening of the arteries are at risk for intestinal angina, essentially lack of adequate blood supply to the gut.  Pain is severe and unrelenting.

Other wonderful conditions such as kidney stones, diverticulitis,bowel obstruction and of course our old friend food poisoning can also ruin your day.  Does this mean that each and every time you have a little upset stomach you should rush to the emergency room?  No, but if the pain is severe, your gut is distended, you have vomited/ had diarrhea or just feel plain awful-come on in.  A word of caution: If your pain improves with antacids this does not necessarily mean that the pain is not coming from your heart.

Next time instead of that pizza maybe a nice bowl of nonfat yogurt with fruit might be in order.