2 months ago
Q: I person a hiatus hernia and my expert has put maine connected lansoprazole. I've publication that proton pump inhibitors (PPIs) for illustration this tin origin Alzheimer's if taken for much than 4 years. Is location immoderate alternative?
Simone Steele, Pembrokeshire.
Dr Martin Scurr replies: A hiatus hernia is erstwhile portion of nan tummy squeezes up into your thorax done nan diaphragm (the musculus that separates your thorax cavity from your abdomen).
In immoderate cases, tummy acerb spills up into nan oesophagus (known arsenic acerb reflux), causing symptoms specified arsenic heartburn, thorax aliases abdominal pain, problems swallowing, recurrent sore pharynx aliases an unexplained cough.
Patients pinch chronic symptoms are often fixed semipermanent prescriptions for a proton pump inhibitor drug, specified arsenic lansoprazole, which reduces nan magnitude of acerb nan tummy produces.
This is important because nan acerb tin harm nan cells lining nan oesophagus, causing a pre-cancerous information known arsenic Barrett's oesophagus.
Treatment for reflux should beryllium based connected nan severity of nan symptoms. Research shows up to 40 per cent of symptoms tin beryllium reduced pinch fare and manner changes
But each medicines person imaginable side-effects, and taking PPIs semipermanent tin bring complications: nan narcotics walk into nan encephalon and person been linked pinch migraine, and problems pinch hearing, imagination and memory.
And, arsenic you say, a study successful nan diary Alzheimer's & Dementia showed that taking PPIs for much than 4 years is associated pinch a higher consequence of dementia.
Treatment for reflux should beryllium based connected nan severity of nan symptoms. Research shows up to 40 per cent of symptoms tin beryllium reduced pinch fare and manner changes — these, on pinch an over-the-counter antacid specified arsenic Gaviscon, are now considered nan first-line treatment.
Lifestyle changes see weight nonaccomplishment for patients whose BMI is adjacent 30 aliases supra (this doesn't use to you, arsenic your longer missive reveals you measurement 8 stone). Common nutrient triggers see caffeine, chocolate, spicy foods, fizzy drinks and peppermint; smoking and intoxicant are besides to beryllium avoided. These each irritate nan valve that stops tummy acerb travelling up into nan oesophagus. And steer clear of eating for 3 hours earlier bedtime; by past nan tummy contents will person moved on, reducing nan anticipation of reflux.
Patients who suffer night-time symptoms — e.g. coughing — besides use from raising nan caput of their furniture (by astir 6 in).
The adjacent measurement is to effort an H2 receptor antagonist (e.g. ranitidine), which reduces tummy acerb but is little powerful than a PPI. If that fails past a once-daily PPI tin beryllium prescribed until symptoms clear. If that doesn't work, you whitethorn beryllium referred for room to extremity nan reflux permanently.
Q: I was told that nan symptom successful my cervix and some shoulders was polymyalgia and was put connected steroid tablets, but I didn't consciousness awesome taking these. When I told my GP, I was told it wasn't polymyalgia truthful to easiness myself disconnected nan tablets. I still person cervix and enarthrosis pain.
Rosemary Rose, Middlesex.
Dr Martin Scurr replies: Polymyalgia rheumatica (PMR) is simply a communal information that causes pain, aching and stiffness astir nan shoulder, cervix and hips, which is usually worse successful nan morning.
Diagnosis is based connected a humor test, and nan modular curen is low-dose steroids, usually prednisolone. This should commencement to resoluteness nan symptoms wrong days — nan truth that you haven't improved is astir apt why nan GP has ruled retired PMR.
I wonderment if nan problem mightiness beryllium deterioration and tear of nan discs successful nan neck. These person to support nan weight of nan caput and complete clip this tin origin arthritis, symptom and stiffness, arsenic bony rubs connected bone. The nerves tin besides go pinched, causing cervix pain. Your enarthrosis symptom whitethorn beryllium nan symptom radiating down from nan neck.
I'd propose asking your GP astir having a scan: X-rays whitethorn beryllium sufficient, though an MRI would supply moreover greater detail. If this is nan problem, physiotherapy would help, but unluckily location is nary imperishable cure.
- Write to Dr Scurr astatine Good Health, Daily Mail, 9 Derry Street, London, W8 5HY aliases email: [email protected].
- Dr Scurr cannot participate into individual correspondence. Replies should beryllium taken successful a general context. Consult your ain GP pinch immoderate wellness concerns.
In my view... Another nail successful nan coffin for GPs
At A clip erstwhile ostentation is astir 4 per cent, backing for GPs successful 2024/25 will emergence by conscionable 1.9 per cent. What galore group don't realise is that nan GP work is carried by astir 7,000 mini businesses. Unlike infirmary specialists, GPs are individual subcontractors who tie astir of their income from a monopoly employer: nan NHS.
The paltry emergence for overheads erstwhile power prices unsocial person doubled — increases shouldered by your section believe — will further compression these mini businesses. Doctors are moving abroad, others are moving to nan backstage assemblage aliases taking early retirement. Whatever nan case, it's diligent attraction that suffers.
I do wonderment if nan existent descent is welcomed by Government, truthful that GP attraction tin beryllium abandoned, leaving expert associates (who person small training) and nurses successful charge, aided by AI.
Doctors would beryllium confined to infirmary work. Am I being paranoid? I don't deliberation so.
