Esophageal erosions tend to recur

DEAR DR. DONOHUE: Several years ago, I was diagnosed with irritable bowel syndrome and erosions in my esophagus. Since then, I have been taking Nexium. Early this year, I began experiencing severe stomach cramping and bloating. I stopped the Nexium, and the cramping and bloating have disappeared. Occasionally I experience some discomfort in my throat that could be acid reflux, and I take Zantac to relieve it.

Because I have stopped Nexium, will I increase the erosions in my esophagus? Does Nexium actually heal the erosions, or does it just reduce the production of stomach acid? -- P.K.

ANSWER: Esophageal erosions are narrow bands of surface ulcerations like the kind that occurs from skinning a knee. Most often, they result from the upward squirting of stomach acid into the esophagus. Nexium (esomeprazole) is one of the proton pump inhibitors, the most powerful suppressors of stomach acid production. With two months of Nexium treatment, 90 percent of esophageal erosions have healed. Since stomach acid causes erosions, you can credit Nexium as healing them.

The problem is that erosions tend to recur. Do you have any heartburn symptoms? If you do, that's a sign that stomach acid is again making its way into your esophagus. You can reduce the chances of having the erosions come back by elevating the head of your bed with 6-inch blocks placed under the bedpost. Cut back on fatty foods; they increase stomach acid production. That also goes for caffeine, chocolate, mints, citrus juices, tomato juice and alcohol.

Let your doctor know what you've done. It's not an unreasonable course of action, since it ended your cramps and bloating. However, the doctor might want you to take a different acid suppressant like the Zantac you are using occasionally.

DEAR DR. DONOHUE: In the past couple of years, I have had a nagging pain in the back of the knee. It is unbearable at times. I want to give it a good punch. My doctor had me take an ultrasound, and I have a large cyst there. The doctor says I have to live with the pain. Isn't there something to rid me of this pain? -- A.J.

ANSWER: A behind-the-knee cyst is called a Baker's cyst. Actually, it's a fluid-filled bursa. Bursas are found throughout the body, and they prevent friction when tendons move over bones. The behind-the-knee bursa connects with the knee joint, and fluid from the joint can travel into the bursa and stay there.

A Baker's cyst is treatable. A doctor can drain the cyst with a syringe and then instill cortisone into it to prevent it from reforming. If that doesn't work, it can be surgically removed. You need to consult an orthopedic surgeon.

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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. 2006 North America Syndicate Inc. All Rights Reserved