DEAR DR. DONOHUE: I am 25. I have a serious case of GERD. I’ve been put on four different medicines. They aren’t working.

I also have palpitations throughout the day. I’ve been told by doctors and nurses that there is nothing dangerous about them. I’d like to know if this true. — J.C.

ANSWER: GERD — gastroesophageal reflux disorder — is heartburn. It’s the upward spurting of stomach acid and digestive juices into the esophagus, the swallowing tube, a place that is not able to cope with these corrosive juices the way the stomach is.

Eliminate or go easy on foods that make GERD worse: citrus fruits; tomatoes; onions; carbonated drinks; spicy, fatty or fried foods; chocolate; peppermint; and caffeine. If you’re overweight, weight loss lessens GERD symptoms. Don’t lie down after eating. Don’t smoke. Sleep with your head, chest and stomach on a slope by putting 6-inch blocks under the bedposts at the head of your bed. That position keeps stomach acid in the stomach. Don’t wear anything that constricts your stomach, like tight pants or tight belts.

Medicines called proton pump inhibitors nearly completely turn off acid production. Nexium, Prevacid, Prilosec, Protonix, Aciphex and Dexilant are their names. If you still have heartburn while on these medicines, it’s OK to use an antacid along with them.

If medicines fail, other causes of heartburn need consideration, things like bile reflux or eosinophilic esophagitis. If these conditions aren’t found, then surgical treatment of GERD is an option that’s open to you.

Palpitations mean a thumping or racing heart. They can be felt as a thud in the chest. The cause is an extra beat — or more correctly, a premature beat — one that comes before it should. The beat after a premature beat is delayed. During the delay, the heart fills with more blood than usual, and that causes a thump in the chest when the heart empties. Premature beats are almost always innocent and need no treatment. You can believe your doctors and nurses.

The booklet on GERD explains this common malady and its treatment. To order a copy, write: Dr. Donohue — No. 501, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: One year ago, my son’s dog was ill and passed away. She was given a blood transfusion and was treated with Imuran at a university vet hospital. After treatment, she had accidents in the home and auto. My son is convinced the home is now unfit to live in. He wears rubber gloves to do ordinary tasks and compulsively washes his hands. His younger child is not allowed to touch him. I am concerned for his wife and children. — D.S.

ANSWER: So am I, and for him. He has gone way over the top. Imuran (azathioprine) is a drug used often on humans for a variety of ills — rheumatoid arthritis, inflammatory bowel disease, autoimmune hepatitis and prevention of rejection of donated organs. No special precautions are taken for others exposed to those who are taking this medicine. If your son can’t get over this on his own, he needs the help of a mental health professional.

DEAR DR. DONOHUE: I read your column on cystitis. You said it was misdiagnosed and not an infection. I can’t find information on it except for a bladder infection. — G.R.

ANSWER: I was speaking of interstitial cystitis, a condition that shares some symptoms with bladder infection cystitis but is entirely different. For unknown reasons, the protective layer of the bladder has been breached, and urine, containing irritative products, bathes and inflames the bladder wall. Incredibly numerous trips to the bathroom to empty the bladder, painful urination, urgency to get to the bathroom and bladder or pelvic pain are its symptoms. Elmiron is one treatment for it. Instilling into the bladder a combination of drugs, along with a pain-deadening medicine, is another.

Contact the Interstitial Cystitis Association, whose website is www.ichelp.org and whose phone number is 800-HELP-ICA. The association can provide you with the latest information on this condition.

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. Readers may also order health newsletters from www.rbmamall.com.

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