DEAR DR. DONOHUE: I need help with acid reflux. I have battled it for seven years, and until recently I have used Prilosec, but it has stopped working for me. I tried AcipHex and Protonix but didn’t feel well when taking them. Now I’m on Prevacid. Is it OK to take indefinitely? I wonder about Nexium. My doctor told me to take any acid reducer that works. What do you consider the best long-term medicine? — F.H.

ANSWER: Acid reflux, heartburn and GERD (gastroesophageal reflux disease) are different names for the same thing — the upward splashing of stomach acid and digestive juices into the esophagus, the long tube that brings food from the throat to the stomach. The esophagus can’t handle those corrosive juices, and the result is burning pain.

Can you identify any food or drink that brings on your symptoms? If you can, eliminate it. Potential troublemakers are fatty foods, fried foods, spearmint, peppermint, chocolate, tomatoes, citrus fruit and caffeine. You prevent nighttime heartburn by putting 6-inch blocks under the bedposts at the head of your bed. In that position, gravity keeps stomach acid in the stomach. Weight reduction almost always lessens symptoms.

I like your doctor’s approach. Use the cheapest medicine that keeps you free of pain. Antacids often can fit the bill: Tums, Rolaids, Mylanta, Maalox and the many others. The most effective medicines are those called proton pump inhibitors: Dexilant, Nexium, Prevacid, Prilosec, Protonix and AcipHex, some of which are available without a prescription. They practically turn off acid production. Some doctors like to have their patients stop use after a year to see if symptoms remit. If they do, so much the better. Less expensive are Tagamet, Pepcid, Zantac and Axid, which cut back on acid production and are obtainable without prescription.

One downside of indefinite use of proton pump inhibitors is the possibility of vitamin B-12 deficiency. Acid is needed to absorb it. The same goes for iron, calcium and magnesium.

The booklet on heartburn (GERD) explains this common condition in great detail, along with its treatments. Readers can obtain a copy by writing: 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: I am 70 years old, and once a week or longer I use the whole or half a dose of Viagra. I get all the symptoms they warn you about in the advertisements. Will these symptoms become permanent: eye and muscle damage? — H.K.

ANSWER: I’m not sure what symptoms are mentioned in advertisements. Headache, flushing of the face, upset stomach, water retention with swelling of the ankles, chest pain, dry mouth and a stumbling walk are some of Viagra’s, Cialis’ and Levitra’s side effects. They’re usually transient and affect only a few users. Muscle pain is another potential side effect. No information says they ever become permanent.

Visual troubles include things like a blue tinge to vision, sensitivity to light and blurred vision. Double vision is another recorded side effect, as are dry eyes and eye pain. Although these are temporary, you should tell your doctor about them. I don’t like to take visual changes lightly.

DEAR DR. DONOHUE: I have a question. My father has never eaten anything sweet in his life. Sweetness makes him sick to his stomach. He has never taken soft drinks, pies, cakes or ice cream. Have you ever heard of this? — R.S.

ANSWER: I haven’t ever heard of someone like your father, but there are many things I have never heard of. I’m sure your dad is in excellent health without eating sweet food. He must have a perfect set of teeth. Sweet things encourage dental cavities. I happen to be a sweets addict. I’m not proud of it.

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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