Greetings, Dr. Roach I am a healthy, energetic 74-year-old woman. The results of my most recent endoscopy showed a 5 cm hiatal hernia with some inflammation. I’ve been experiencing episodes of acid reflux nearly every day.
I was prescribed 40 mg of omeprazole for six weeks by the gastroenterologist. I experienced no acid reflux or stomach ache, and it worked flawlessly for me. The doctor advised me not to take it every day after the regimen was finished. However, he advised me to take 20 mg of the over-the-counter (OTC) dose every other day if I was serious about taking it. (When I tried this, it worked well for me.) He also advised me to either surgery to repair the hernia or use Pepcid to treat any future acid issues.
During my routine checkups, my usual physician approved the low-dose, over-the-counter omeprazole. Could you tell me what you think of this? — G.P.
ANSWER: Vital structures must pass via the diaphragm, a big muscle that divides the chest from the abdomen. Therefore, the hiatus is a hole in the diaphragm. The stomach (and occasionally other abdominal contents) can enter the chest cavity due to a weakening in the hiatus where the esophagus passes through, known as a hiatal hernia.
Acid reflux, or stomach acid flowing backward into the esophagus, is the main sign of a hiatal hernia. Therefore, acid reflux is treated in the same way as a symptomatic hiatal hernia.
After identifying inflammation, your gastroenterologist prescribed an antacid regimen that lasted long enough for the irritation to subside. You shouldn’t require so much medication to avoid issues in the future. It is understandable that your gastroenterologist is worried about the long-term adverse effects of omeprazole and other proton-pump inhibitors. He appropriately presented you with the choices of surgery, a different type of medication known as an H2 blocker (Pepcid), or a low-dose PPI, in my opinion.
Pepcid or comparable medications are the safest of these alternatives, therefore I typically suggest them as my first pick. I will suggest a low-dose PPI if my patient’s symptoms are still intolerable. In order to avoid a lifetime of medicine, surgery is most commonly performed on patients who do not respond to treatment and occasionally on young patients with severe symptoms.
Greetings, Dr. Roach I would like my ears to be candled. Although I’ve heard positive things about it, I’ve never heard a doctor suggest it. How do you feel about ear candling? — B.M.
ANSWER: One method for getting rid of extra ear wax is ear candling. According to some, it could benefit other ailments like temporomandibular joint abnormalities or Meniere’s illness. There are even more outrageous claims about its capabilities.
Please don’t try it and don’t believe these false claims. The risks are obvious and include burning from melted wax, puncturing your eardrum, and pushing wax farther into your ear. Ear candling resulted in two house fires, one of which proved lethal. There is a definite risk of injury and no benefit.
Although he regrets not being able to respond to each letter individually, Dr. Roach will try to include them in the column. Questions can be sent by mail to 628 Virginia Dr., Orlando, FL 32803 or by email to [email protected].
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