Dear Dr. Donohue: Is it true that those of us who have to take Prilosec every day are in danger of getting a bone fracture? Should we consider stopping it?
Anon.
We need to give readers a clue to what we're talking about. The subject is GERD, gastroesophageal reflux disease, something most call "heartburn." It's the eruption of stomach acid and digestive juices into the esophagus, a place not built to withstand those powerful fluids.
Proton-pump inhibitors are the most effective suppressants of acid production. There are eight: Prilosec (omeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), Dexilant (dexlansoprazole), Tecta (pantoprazole) and Aciphex (rabeprazole).
These medicines have made life livable for people who don't respond to other strategies or medicines for heartburn control.
All effective medicines have side effects. A side effect of proton-pump inhibitors is weakening of the hip bone with possible fracture of it. It's not a common occurrence. When it happens, it happens to those who have taken high doses of these medicines for five to seven years. As a preventive step, take a protonpump inhibitor at the lowest dose that controls symptoms and for the shortest time possible. You can resume taking it if and when heartburn returns.
You also can try acid suppressants that don't have this side effect: Tums, Rolaids and Maalox. Don't eat foods that cause you to have heartburn. Frequent offenders are excessive amounts of caffeine, chocolate, alcohol, peppermint, fatty foods, citrus fruits and tomatoes. Or try a different family of acid suppressants. Zantac (ranitidine), Pepcid (famotidine) and Tagamet (cimetidine) are examples.
I wouldn't use the unapproved treatment mentioned in the letter you sent. It appears that its distributor is playing on exaggerated fear.
Dear Dr. Donohue: I always buy orange juice marked "not from concentrate." I read somewhere that such juice is lacking in some things. Can you explain?
F.H.
"Concentrate" indicates that water has been evaporated from the juice. That extends its life, and makes t easier to ship and store. rior to sale, it is reconstiuted with water. Or it may e a frozen product to hich the buyer restores ater.
There's little difference in the nutritional value and vitamin content of concentrated juice. I just checked. It's the kind of orange juice I drink every morning.
Dear Dr. Donohue: My father was colour-blind. Of his four daughters and one son, two of his daughters were colour-blind. I just found out that two of his three grandsons and eight of his nine great-grandsons are colour-blind.
How common is this? S.
Colour-blindness affects eight per cent of men, but only 0.4 per cent of women. It is, therefore, 20 times more common in men than women.
It's surprising that two of your sisters have it. Less surprising is the number of grandsons and great-grandsons with it.
Most colour-blind people get along in life without much trouble. And most have some degree of colour perception. A very few see the world only in greys, black and whites.
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 at P.O.
Box 536475, Orlando, FL 328536475.
