DEAR DR. DONOHUE: I began to get chest pains about six months ago. At first I ignored them, but they continued, and I saw my doctor, who sent me to a heart doctor. The heart doctor says I have aortic stenosis and has mentioned surgery. I take nitroglycerin, and it helps the pain. Can’t I just stay on that? – B.M.

ANSWER: The aortic valve prevents blood from leaking back into the heart after it has been pumped out of the heart. Aortic stenosis is a narrowed valve. Narrowing obstructs the free flow of blood out of the heart. The heart has to pump harder to empty, and years of strenuous pumping produce an enlarged heart. A heart can enlarge only so much. Unrelieved pressure on the heart can lead to a number of serious consequences.

One consequence is a diminution of blood flow to heart arteries. That produced the chest pain you had. Nitroglycerin is one drug that can relieve that symptom, but it will not correct the narrowed valve.

Another consequence of the constant, increased demand on a heart is congestive heart failure. The heart tires out and can no longer completely empty the blood that’s in it. Blood backs up into the lungs and makes a person short of breath. Medicines can also relieve symptoms of congestive heart failure, but these medicines don’t heal the valve, either.

Surgery is the only way to correct the valve problem. It becomes a matter of urgency when symptoms such as chest pain, breathlessness or fainting – another aftermath of aortic stenosis – begin and increase in severity. I am certain your heart doctor will ask you to submit to a cardiac catheterization, the procedure where dye is injected into the heart and the heart arteries. The cath gives an accurate assessment of how narrow the valve is and how great the strain on the heart is. If information indicates the need for valve replacement, don’t hesitate to have it done. Surgery is the only cure for this problem.

DEAR DR. DONOHUE: My 4-year-old grandson has Hirschsprung’s disease. Almost from birth he was troubled with constipation. My daughter finally took him to a medical school because of his constipation, and this is where the diagnosis was made. Please tell me more about it. Will it affect his development? – M.N.

ANSWER: In Hirschsprung’s disease, parts of the colon and rectum are missing their nerve connections. It’s a glitch that occurs during fetal development. When the missing connections are many, troubles begin shortly after birth and usually become obvious quickly. The baby is chronically constipated and fails to gain weight. Your grandson must have some connections intact, or the condition would have been recognized much sooner. Some people aren’t diagnosed until adolescence or even young adulthood.

Treatment is removal of the affected section of colon or rectum. The outlook is usually quite good.

DEAR DR. DONOHUE: Do people shrink when they grow older? I used to be 5 feet 9 inches and now am 5 feet 7 ½ inches. Could I be measuring wrong? – R.T.

ANSWER: We do shrink. We lose about an inch during life. Disks between backbones dry out and shrivel, and that accounts for some of the height loss. Osteoporosis, in men and women, compresses backbones and accounts for more height loss.

I don’t know of any way to get the height back. A lifetime of exercise keeps bone and height loss to a minimum.

DEAR DR. DONOHUE: I have GERD and take Aciphex for it. Can I intersperse it with Pepcid (every other day) to cut expenses? Pepcid is cheaper. My doctor said I could, but my druggist doesn’t agree. Your advice, please. – R.A.

ANSWER: I couldn’t find an answer for you, so I consulted my panel of experts, who say they find that alternating the two medicines is OK – unless your symptoms return. Aciphex is a proton pump inhibitor. It shuts off acid production. Pepcid is a histamen-2 antagonist. It decreases acid secretion.

Don’t take both drugs on the same day.

For readers, GERD – gastroesophageal reflux disease – is heartburn.

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 or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.