DEAR DR. DONOHUE: I have had heartburn for many years, and it has gotten worse this past year. My doctor sent me to a specialist, who looked into my esophagus and stomach with a scope. He said I have Barrett’s esophagus and that it can turn into cancer. I’ve been quite nervous about this. What are the chances that I’ll get cancer? – M.T.
ANSWER: Heartburn’s official name is GERD – gastroesophageal reflux disease. Reflux is a backup of stomach acid into the esophagus, a place that’s not designed to tolerate stomach acid. The result is heartburn. In some people with chronic heartburn, stomach acid causes a change in the lining cells of the lower part of the esophagus. That’s Barrett’s esophagus.
Barrett’s can progress to esophageal cancer. Keep in mind that heartburn is common and cancer of the esophagus is uncommon, so the cancer progression is rare. Even though it’s never been shown that control of reflux prevents cancer, you should be taking steps to limit heartburn. Stay away from chocolate, peppermint, caffeine, alcohol, fatty foods, fried foods, citrus fruits and many tomato products. Elevate the head of your bed by placing 6-inch blocks under the bedposts so gravity keeps stomach acid in the stomach during the night. I have to believe your doctor has you on medicines that greatly diminish acid production, like Nexium, Prilosec, Prevacid, Aciphex or Protonix.
The cancer scare is real but remote. It shouldn’t dominate your life. You’ll be on a schedule of follow-up scope exams, and the doctor will take immediate steps if dangerous changes are seen. Those steps include surgery or inactivating any suspicious cells with drugs that make them sensitive to light exposure. You are actually in a safer situation than are people who develop Barrett’s esophagus without any symptoms. You’re being watched.
The booklet on GERD – heartburn – describes this common disorder and its treatment. Readers can obtain a copy by writing: Dr. Donohue – No. 501W, Box 536475, Orlando, FL32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Quite often, my nose drips when I eat. I don’t mind when I’m at home, but it’s humiliating when I eat out. Is this an allergy? What works for it? – A.S.
ANSWER: It’s not an allergy. The condition has a name – gustatory rhinorrhea. You wouldn’t believe the number of letters I get that ask about it.
No one is sure why it happens. Spicy and hot foods are most troublesome. Some doctors suggest it might be a reflex triggered by chewing. Others say food odors are responsible.
One hour before eating in public, take an antihistamine. Many are available without a prescription. If antihistamines don’t turn off the fountain, try a decongestant. Decongestants are also available without prescription. Take them an hour before eating also. You don’t need to take them at home or before every meal. Save the medicine for the times you dine out.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL32853- 6475.
©2007 North America Synd.