Q: I’m on a protein pump inhibitor to manage my chronic heartburn but it doesn’t seem to work anymore. What are the alternatives? Brian P., Dearborn
A: Switching to an H2 Blocker is a good alternative. H2 Blockers reduce acid, are often prescribed as PPI alternatives and are sold over-the-counter (Zantac, Pepcid, Tagament). The respective generic versions (ranitidine, famotidine, cimetidine) cost less than the brand names but require a prescription from your doctor. In the meantime, do some anti-reflux measures to help manage your symptoms — elevate the head of your bed so you are raised up slightly when you sleep, and avoid foods that worsen reflux (such as caffeine, chocolate and carbonated beverages).
Q: Is it possible that my gastritis was caused by not having my teeth cleaned as often as I should? Darlene W., Flat Rock
A: Right now, there are interesting studies in the medical community that are linking oral health with body health. Your teeth and gums harbor bacteria that are harmless when controlled by proper oral hygeine, but when out of control, may play a role in cardiovascular disease, diabetes, osteoporosis and many other health problems. Nothing is proven yet about specific digestive tract disorders, but it is possible.
Q: As I get older, I am having constipation more often. Is it best to use one kind of laxative or try a variety of foods and medicines? What do you think works best? Chelsea C., Woodhaven
A: With mild constipation I do not recommend starting with laxatives over-the-counter. First, try a natural approach and start with lifestyle modification. Increase your fiber intake by eating more whole grains, beans, fruits and vegetables. At the same time, increase your water intake to receive the full benefit of the additional fiber. If the fiber-fluid regimen is not working well enough, then I would add an an over-the-counter fiber regimen too. If lifestyle modification and fiber supplements still are not helping, then escalate to laxative medications under the guidance of your doctor.
Rana Sabbagh, M.D., is board-certified in internal medicine, gastroenterology and nutrition. She is the founder of GastroCenter of Michigan and Experior Weight Loss Clinic, 23500 Park St., Suite 2B in Dearborn. Do you have a health question for Dr. Sabbagh? Submit it by email to: [email protected]
All information provided in Ask The Doctor is intended for your general knowledge. Consult with your personal doctor or pharmacist for any specific health or nutrition issues. Never disregard professional medical advice or delay seeking medical treatment because of information you have read in any publication.