DEAR DR. DONOHUE: I have recently been diagnosed with LPR, laryngopharyngeal reflux. Can you explain it and what the prognosis is? — E.M.

ANSWER: Laryngopharyngeal (luh-RING-oh-fair-in-GEE-ul) reflux is the throat version of heartburn. It’s the upward splashing of stomach acid and digestive juices into the throat (pharynx) and voice box (larynx). The result is a strained voice or outright hoarseness, sometimes with difficulty swallowing and a cough. The diagnosis is made by what the patient says his or her symptoms are along with a scope inspection of the throat and the vocal cords.

Surprisingly, only a minority, around a third, of these patients actually suffer heartburn symptoms.

Dietary treatment is important. Avoid both caffeinated and decaffeinated beverages, carbonated beverages like soft drinks, and alcohol. You ought to cross off chocolate, peppermint, citrus fruits, tomatoes, jams, jellies, and salad dressings from your diet. Don’t eat spicy foods or drinks.

Smaller but more frequent meals lessen the chances that stomach acid will find its way into the throat. Raising the head of the bed by putting 6-inch blocks under the bedposts keeps stomach juices in the stomach during the night.

Treating this disorder with medicines that suppress acid production is debatable. Such treatment is encouraged if the person also has heartburn. Medicines also are useful if symptoms are intolerable. By medicines, I’m talking about drugs like Prilosec (omeprazole), Prevacid (lansoprazole) and Nexium (esomeprazole).

The prognosis is good.

DEAR DR. DONOHUE: I have been diagnosed with atrial flutter. My cardiologist wants to perform a catheter ablation on me and says it’s a safe procedure. Do you agree? — B.L.

ANSWER: Atrial flutter is a very rapid heartbeat. The atria, the two upper heart chambers, beat 260 to 300 times a minute. The lower heart chambers, the right and left ventricles, the heart’s pumping chambers, beat at half that rate, still a fast heartbeat.

Atrial flutter differs from atrial fibrillation, a more common heart-rhythm disturbance, in the regularity of the heartbeat. Atrial fibrillation is both an irregular and fast heartbeat. Atrial flutter is a regular and fast beat.

Fatigue, lightheadedness and shortness of breath are some of atrial flutter’s symptoms.

The heart can’t be allowed to sustain such rapid beating. Ablation, the destruction of heart tissue responsible for the speedup, is an excellent way to put an end to flutter. The heart doctor with a specially equipped catheter advances this thin, pliable tube from a surface blood vessel into the heart. When the doctor has the catheter at the right position, he or she turns on radio waves that create scars in the renegade part of the atrium. The abnormal rhythm stops. The success rate is 90 percent. I wouldn’t hesitate a minute to have it done.

The booklet on heartbeat irregularities explains the more common kinds of heartbeat disturbances. To obtain a copy, write: Dr. Donohue — No. 107, 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: My father and two uncles died from heart attacks when they were in their 50s. I’m 45. I haven’t ever smoked. I am active and eat a healthy diet. Should I be taking an aspirin? What dose? — R.W.

ANSWER: A family history like yours puts you at high risk for a heart attack. I would take a daily 81 mg aspirin as a preventive step.

You shouldn’t do this on your own, however. Discuss it with your family doctor to see if he or she has any other suggestions or tests planned for you.

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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