DEAR DR. ROACH: I am writing concerning being a MRSA carrier. A friend and her kids were tested and are carriers. She got it from working at a nursing home. They attend our church and local school. Could you please give advice for us and our kids on how to stay healthy when you know you will be in contact with a MRSA carrier? How is it spread? What is the best way to prevent it? What about a visit at school or home? Is there anything we can do to help the family, and is there any way to get rid of it once you are a carrier? Any and all advice would be appreciated, since prevention is the best medicine. — I.R.

ANSWER: We all carry around bacteria on our bodies. No amount of washing can ever eliminate all bacteria.

“MRSA” stands for “methicillin-resistant Staphylococcus aureus.” Staphylococcus aureus is the organism of the very common “staph infection” (usually a skin infection, such as a boil), and “MRSA” means that it is resistant to most usual antibiotics used for these infections. Being a carrier for MRSA does not mean that person is infected with it; however, if a carrier develops a staph infection, it is more likely to be resistant. Fortunately, there are effective treatments for MRSA infection.

It’s not clear whether carriers should be treated. What is clear is that you should use the same kind of sensible precautions that you’d use around anybody — wash your hands frequently, and seek treatment promptly for any breaks in the skin that exhibit redness, unusual pimples or skin areas that look like spider bites.

It is possible to become a carrier from contact with other carriers, but most healthy carriers for MRSA never develop any infections or problems.

DEAR DR. ROACH: Please discuss esophageal spasm and its treatment. The chest pain can be quite intense. What is the cause of this condition?

ANSWER: Esophageal spasm is a contraction of the muscles of the esophagus, the muscular tube that connects the back of the throat with the stomach, the one down which food travels. As you mention, spasm of this muscle can cause a severe pain in the chest that can present exactly like a heart attack. The cause of esophageal spasm is unknown, but very hot or cold foods sometimes may trigger an attack.

The diagnosis of esophageal spasm is usually is made after first making sure it’s not, in fact, heart disease or some other life-threatening condition. A gastroenterologist may measure the pressures in the esophagus, which is the definitive way to make the diagnosis. Most commonly, esophageal spasm is treated with medication. Nitroglycerine can stop a spasm immediately (which can further confuse it with a heart attack), but blood pressure medicines like nifedipine are effective in most people. Occasionally, a procedure to dilate the esophagus or even surgery may be necessary.

TO READERS: The booklet on heart attacks, America’s No. 1 killer, explains what happens, how they are treated and how they are avoided. Readers can order a copy by writing: Dr. Roach — No. 102, 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.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or request an order form of available health newsletters or mail questions to P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from

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