Greetings, Dr. Roach I’m 81 years old and doing fairly well. I frequently struggle to get asleep and stay asleep. I took two ibuprofen tablets before bed for several nights in a row a few months ago since I was having trouble sleeping because of a hurting lower back from doing too much yard work. I observed that I was able to fall asleep more quickly.
I’ve been taking ibuprofen as a sleep aid, and it still helps me fall asleep. However, I’m curious as to whether taking ibuprofen every day could lead to any health problems. J.T.N.
ANSWER: Ibuprofen is not a good sleep aid in general because most people don’t find that it improves or detracts from their sleep. In reality, ibuprofen may cause sleep disturbances for certain people. However, some people discover that it makes them drowsy.
In any event, taking two ibuprofen pills at night—or even daily—carries a minimal risk. Ibuprofen shouldn’t be taken regularly by someone who has a history of ulcer disease or unusual bleeding without first talking to their doctor.
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Greetings, Dr. Roach You recently stated that probiotics are not advised for healthy individuals. I am a 78-year-old man who had an esophagectomy three years ago to remove my esophagus and a portion of my stomach due to cancer. Pantoprazole dosage was started at 30 mg and subsequently raised to 40 mg. I’ve read that using this medication for an extended period of time is not advised.
According to what I understand, the purpose of this medication is to lessen the likelihood of acid reflux. According to what I’ve read, it also eliminates both beneficial and harmful microorganisms in the stomach. In order to assist reestablish the beneficial bacteria, I asked my primary care physician whether she was comfortable with me taking probiotics. — E.M.
ANSWER: Following surgery for esophageal cancer, patients are frequently prescribed proton-pump inhibitors, such as pantoprazole. They reduce acid reflux and consequently prevent a stricture where the remainder of the esophagus was connected with the remainder of your stomach.
While it is true that proton-pump inhibitors do have the potential for side effects with long-term use, there are times when the benefits outweigh the risks. Many esophageal cancer experts feel that the benefits outweigh the risks in esophageal survivors like you.
Long-term acid suppression does lead to changes in the gut bacteria, called the microbiome. Using probiotics to improve the quality of the microbiome has been studied, and preliminary studies showed that taking probiotics daily can get more healthy bacteria in the gut. What isn t clear is whether this translates to better outcomes for the patient or whether any of the long-term adverse effects of proton-pump-inhibitor therapy will be reduced. It makes sense that it might help, but it is unproven as yet.
There is the potential for harm in probiotic treatment, but it s not common. A very few cases of infection have been shown to be transmitted by probiotics. The main harm is mostly financial, since some probiotics are expensive.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions [email protected] send mail to 628 Virginia Dr., Orlando, FL 32803.
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