DEAR DR. DONOHUE: For many years, I had heartburn, and I lived with it by taking things like Tums. Finally, I consulted a doctor, who referred me to a gastroenterologist because he was alarmed at the length of time I’d had it. The gastroenterologist gave me a scope exam of my esophagus and stomach. It turns out I have GERD and something called Barrett’s esophagus, which turns into cancer. Naturally, I am nervous. I’ve never heard of heartburn-caused cancer. How often does that happen? — A.S.
ANSWER: Not often, but enough that plans have to be made to keep checking for such a change.
Heartburn is officially called GERD, gastroesophageal reflux disease. Stomach acid squirts upward (refl uxes) into the swallowing tube, the esophagus. The esophagus isn’t built to deal with stomach acid the way the stomach is. The result is heartburn.
Medicines for GERD are many. The ones most often chosen are proton-pump inhibitors, medicines that all but turn off acid production. Their names are Prevacid (lansoprazole), Dexilant (dexlansoprazole), Prilosec (omeprazole), Nexium (esomeprazole), Protonix (pantoprazole) and Aciphex (rabeprazole).
Up to 12 percent of GERD patients, even with treatment, develop Barrett’s esophagus. The lining cells of the lower part of the esophagus change into ones that are more resistant to stomach acid. That change can evolve into another transformation that is precancerous. That’s called dysplasia. Dysplasia can then become cancer. The absolute risk for this is small, but it is real, and has to be carefully looked for.
If the Barrett’s cells show signs of low-grade dysplasia, then a follow-up scope exam of the esophagus is done in six to 12 months and repeated annually. If high-grade changes are found, the scope exam is repeated every six months. If no dysplasia changes are seen, follow-up exams are scheduled for every three years.
The booklet on hiatal hernia and GERD gives a comprehensive treatment on this subject. Readers can obtain a copy by writing: Dr. Donohue — No. 501W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I am a senior citizen. For the past five years I have received Botox injections and wonder where the Botox goes after it leaves the injection site after about six or seven months. Does it stay in the body forever? Does it go to an organ?
Suddenly, I am worried about this. — S.B.
ANSWER: The body, as it does with all injected medicines, breaks down Botox, and the breakdown products are eliminated. It’s the way nature takes care of all foreign materials that find their way into our bodies.
DEAR DR. DONOHUE: All my friends have menstrual cycles that last 28 days. Mine don’t. They vary from 23 to 34 days. Is that normal?
I feel fine. I am 23 and active. My periods are not painful. — J.F.
ANSWER: The average menstrual cycle is one of 28 days. That’s only an average. The cycle can vary from 21 to 35 days and still be considered normal.
Readers may write Dr. Donohue or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
©2012 North America Synd.