DEAR DR. DONOHUE: I am 78 and in good health. My family doctor of 25 years retired, and my new doctor has a list of the pills I take. I have taken omeprazole (Prilosec) for six years because of bleeding from the stomach. I believe I caused the trouble by taking aspirin. My new doctor wants me to take famotidine (Pepcid). Its side effects are not good. I am having trouble. What should I do? — R.S.

ANSWER: You had a bleeding ulcer. Whether it was from taking too much aspirin, I can’t say. I can tell you that the treatment of ulcers has had major changes from the treatment given 25 years ago. In those days, the prevailing idea was to treat ulcers forever since they came back so often. The general feeling was “once an ulcer, always an ulcer.” That’s no longer true.

We now know that the two most common causes of ulcers are the bacterium Helicobacter (HE-lick-oh-BACK-tur) pylori (pie-LORE-ee) and aspirin or other nonsteroidal anti-inflammatory drugs like Advil, Aleve and Motrin. Today’s treatment, therefore, includes using antibiotics to rid the stomach and duodenum of the bacterium and to eliminate the constant use of aspirin and NSAIDs.

Helicobacter bores holes in the layer protecting the stomach and duodenum. Holes allow stomach acid to attack the walls of those structures, which, in turn, brings on an ulcer and possible bleeding.

In addition to the antibiotic treatment (two or three weeks with two antibiotics) are four weeks of suppressing stomach acid with a drug like omeprazole (Prilosec). Eliminating the bacterium while stopping acid production allows the ulcer to heal. The chances for a return of an ulcer are very slim once the Helicobacter germ has been gotten rid of.

From this point on, you won’t need an acid suppressant. Your ulcer is healed and has stayed healed for six years. If there’s any question, have your doctor check for H. pylori. If it’s not present, you do not need to be taking either medicine.

DEAR DR. DONOHUE: Each year when the cold weather sets in, the tips of my fingers crack open. They bleed and are very sore. Hand creams, wearing gloves and even an antibiotic cream have not helped. I am a 59-year-old woman, and this has been happening since I was in my 20s. — T.Y.

ANSWER: Cold, dry winter air does a job on the fingertips. The skin splits apart. It’s a common happening in Northern climates. Here’s a tip that might work: Cover your fingertips with petroleum jelly. Then wrap them firmly with an adhesive bandage. Apply a second bandage at right angles to the first, and be sure the bandage is firmly in place. Do this at night. Do it for the daytime, too, if you can. It should be done for three consecutive days.

A reader once gave another tip. She experimented with different creams and found that Nexcare mediated bandages solved her problem. She found them at Walgreen’s drugstores.

DEAR DR. DONOHUE: I am a 73-year-old male in good health but have hypertension. What are the dangers of skipping and starting the prescribed medicine? Or in taking the pill only when my blood pressure reading is high? Do you consider high blood pressure medicine a daily, lifetime medicine? — R.L.

ANSWER: Some people are able to get off high blood pressure medicine if they make changes in their lives: greatly reduce salt intake, lose weight and exercise daily. Most people have to take their medicine every day for life.

Stopping and starting the medicine is dangerous, because you don’t know what your blood pressure is at all times during the day and night. You could miss the peaks of blood pressure, which can damage your arteries, eyes, heart and kidneys. Besides, you have to build up a level of the medicine before it works.

The unfortunate thing about high blood pressure is that it doesn’t produce symptoms until late, when damage has been done.

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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