Digestive Disorders

Will I be okay if I stop taking a PPI for my heartburn?

DEAR DOCTOR K: For years I've been taking a PPI twice a day for heartburn. My doctor wants me to cut back, or stop altogether. But the idea frightens me. Do you think it's possible?

DEAR READER: To anyone tormented by frequent heartburn, not taking your daily tablet -- or tablets -- of omeprazole (Prilosec) or lansoprazole (Prevacid) might seem like a scary idea. These and similar drugs, known as proton pump inhibitors (PPIs), are the foundation of treatment for heartburn, also known as gastroesophageal reflux disease (GERD).

Will fiber or probiotics help with my irritable bowel syndrome?

DEAR DOCTOR K: I have irritable bowel syndrome with alternating constipation and diarrhea. Will eating more fiber help? What about probiotics or other non-medical treatments?

DEAR READER: Irritable bowel syndrome (IBS) is a common intestinal disorder with many unpleasant symptoms. Many people with IBS go back and forth between diarrhea and constipation, with pain and bloating in between. Others always have diarrhea or constipation.

What is intestinal angina?

DEAR DOCTOR K: For months I've experienced severe pain in my abdomen after eating. After excluding a number of other conditions, my doctor diagnosed intestinal angina. I've heard of angina related to the heart -- is this the same?

DEAR READER: The underlying process is the same for intestinal and cardiac angina. Let me explain.

What lifestyle changes can help relieve my heartburn?

DEAR DOCTOR K: Can lifestyle changes help relieve my heartburn?

DEAR READER: Heartburn is an uncomfortable burning sensation that radiates up the middle of your chest. It results from a condition called gastroesophageal reflux disease (GERD), or "reflux." With GERD, stomach acid surges up into the esophagus, the "swallowing tube" that connects our mouth to our stomach.

Is it okay to take a PPI for heartburn indefinitely?

DEAR DOCTOR K: I've had heartburn for years, and I began taking Prilosec as soon as it became available. It gives me relief, but I worry about taking any drug for a long time. Should I be worried?

DEAR READER: As I've often said, no drug is 100 percent safe. That doesn't mean that you shouldn't take one if you need it. But you should continually weigh the risks and benefits.

What is an abdominal aortic aneurysm?

DEAR DOCTOR K: I had pain in my abdomen, so my doctor did an ultrasound to check for gallstones. It turns out I have an abdominal aortic aneurysm. What is that?

DEAR READER: The aorta is the body's largest artery. It carries oxygen-rich blood from the heart to every part of the body. The aorta curves out of the heart and through the chest, then passes down the center of the body before dividing into the arteries that serve the legs.

What diet can help with IBS?

DEAR DOCTOR K: I have irritable bowel syndrome (IBS), and I hear there is a diet to help that. Can you tell me about it?

DEAR READER: Unfortunately, IBS is pretty common. Symptoms include cramping, diarrhea, gas and bloating. But you are right: Research has identified certain foods that tend to trigger IBS, and avoiding these foods can help you reduce your symptoms.

Should I stop taking my PPIs?

DEAR DOCTOR K: I've been taking PPIs for years to treat my heartburn. Now I hear they might increase my risk for a heart attack. Should I stop taking them?

DEAR READER: Proton pump inhibitors, or PPIs, are antacid drugs used to treat some ulcers, heartburn (GERD) and other causes of upset stomach. These popular drugs include the brand names Prilosec, Nexium and Prevacid. PPIs, available over the counter, have been considered quite safe.

Which laxative should I take for my constipation?

DEAR DOCTOR K: There are so many laxatives on the market. Which one should I take for my constipation?

DEAR READER: Anyone suffering from constipation should start by boosting fiber and fluid intake. That may do the trick, and you may not need a laxative. If you are age 50 years or younger, the target is 38 grams of fiber per day for men and 25 grams per day for women. For men and women over 50, aim for 30 and 21 grams per day, respectively.