Q: I have had difficulty with reflux since childhood. Proton-pump inhibitors such as Prilosec and Prevacid have helped with the heartburn pain, but did nothing for reflux. The reflux became violent projectile vomiting without nausea. Physicians have been unable to determine the cause.
After reading your Guide to Digestive Disorders, I began to chew gum following moderate to large meals. This simple suggestion has all but stopped the reflux, which is no longer troublesome. Thank you.
A: Chewing gum stimulates saliva, which washes acid and other stomach juices back down the esophagus into the stomach and alleviates symptoms. While acid-suppressing drugs reduce the irritating effects of stomach contents, medications like Nexium and Prilosec do not prevent reflux.
In recent years, we have learned that long-term use of PPIs has been linked with a number of complications, including an increased risk for pneumonia, diarrhea due to C. diff infections, vitamin and mineral deficiencies and weakened bones. The most recent side effect to be documented is kidney failure in older patients (CMAJ Open online, April 16, 2015).
We discuss the pros and cons of PPIs and many nondrug approaches to heartburn, including a popular recipe for persimmon punch, in our Guide to Digestive Disorders. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. G-3, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
Q: You have often written about nasal-spray addiction. The solution is simple, as I discovered by accident. After using Afrin daily for years and trying unsuccessfully to stop, I bought a bottle of Nasacort 24HR (OTC). I stopped the Afrin and used two squirts of Nasacort in each nostril for 20 days.
I noticed an improvement after a couple of days, but kept using it until my nose opened. Then I stopped the Nasacort with no trouble. Addiction cured!
A: The official term for nose-spray addiction is rhinitis medicamentosa. A corticosteroid spray like Nasacort Allergy 24HR (triamcinolone) or Flonase (fluticasone) can reduce inflammation and swelling to ease withdrawal from decongestants (Treatments in Respiratory Medicine, February 2005).