DEAR DR. DONOHUE: Please explain the difference between Protonix and the other medications available for GERD. I have been on Protonix for nine months, and no one is able to give me a clear definition. – E.S.
ANSWER: Heartburn, acid reflux, hiatal hernia and gastroesophageal reflux disease are different names for the same condition – the upward spurting of stomach acid and digestive juices into the esophagus, the long muscular tube that stretches from the throat to the stomach and through which food travels to arrive in the stomach.
The medicines that are the most powerful in suppressing acid production, and therefore in quieting heartburn symptoms, are proton pump inhibitors. “Proton” is another word for “acid.” There are five of them: Prevacid, Prilosec, Nexium, Aciphex and your Protonix. They work in a similar fashion. Each has its own slightly different profile and its own slightly different set of side effects. Which is best? The best one for you is the one that stops your heartburn, causes you the fewest side effects and costs the least.
There are many other GERD medicines – simple antacids like Maalox, for example. Tagamet, Zantac, Axid and Pepcid cut acid production in different ways from the proton pump inhibitors. If they work for a person, then he or she should stick with one of them.
Raising the head of the bed with 6-inch blocks under the bedposts or lying on the left side while asleep keeps stomach acid in the stomach and can put an end to some people’s heartburn without resorting to medicine. Staying away from caffeine, citrus fruits and juices, tomatoes and tomato products, chocolate, peppermint, onions and fatty or fried foods is another approach to minimizing heartburn symptoms.
The booklet on GERD (heartburn and hiatal hernia) explores this topic in full. Readers can order 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 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: A psychiatrist recently diagnosed my 20-year-old granddaughter with dysthymia. Can you explain what it is? – B.L.
ANSWER: Dysthymia is sadness that lingers for no good reason. It’s not quite the depths of dejection that qualifies as a major depression, but it is a state of a down mood that affects a person’s life and work. Dysthymic people have little energy, have poor appetites, are unable to sleep or sleep excessively and are consumed with pessimism.
With direction from a mental health professional and perhaps with medicines to right any imbalance of brain chemistry, most dysthymics can obtain relief.
DEAR DR. DONOHUE: I am 67 and have high blood pressure, high cholesterol and arthritic knees. Walking was my favorite exercise, but knee pain now prevents that. What exercise would be best for my knees? – R.C.
ANSWER: Swimming would be the ideal exercise. Even if you don’t know how, 67 is not too old to learn. You also could do water aerobics – exercising in the water. Water provides buoyancy that protects your knees.
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.
©2008 North America Synd.