SUNDAY MAGAZINE

Ask the doc

Dr. Neeraj Gupta, Consultant General Physician, Safdarjung Hospital, New Delhi, replies to this week's questions.I AM 50 years old and am suffering from indigestion, gastritis and hyperacidity for about a year. I was treated for spondylitis with Tizan SR (6 mg). Forthe past year, I feel nauseous if I eat spicy food. After two hours, vomiting occurs several times till the stomach is empty. This has occurred thrice in the last one year. Since then I eat only home cooked vegetarian food. Though this has helped reduce the intensity, I now have constipation along with headache and sleeplessness. I take two tablets of Zinetac (150 mg) daily after lunch and dinner. Earlier I took a course of PAN-40 (one tablet every morning). If I stop the medication, the problem starts again. Is there any way to solve this problem permanently? JeetAnswer: Your symptoms are suggestive of hyperacidity, the causes of which include ulcers of stomach or duodenum, erosive or ulcerative gastro-oesophageal reflux disease, acid producing tumours, gastritis due to certain drugs or Heliobacter pylori infection. The medicine for spondolytis may have worsened the problem. Considering your age and duration of symptoms, an UGI endoscopy investigation is a must to rule out any serious disorders of stomach or duodenum. Ultrasound investigation is also required to exclude gallstones, which are notorious for causing non-ulcer dyspepsia, H. pylori infection can easily be ruled out by a simple kit. Treatment includes symptomatic management of acidity with newer and safer proton pump inhibitors along with prokinetic agents (like rabeprozole with domperidone etc). Consult an experienced gastroenterologist for proper management.I SUFFER from hyper acidity for nearly 15 years. I have been taking "ITZA RB" for six months. I would like to know if there is any side effect and can I continue it lifelong? I am presently 52 years old. Does acidity lead to cancer? Rashid AhmedAnswer: Firstly, no medicine can be taken lifelong without side effects. Your chronic condition, especially with advancing age, can lead to serious stomach problems and therefore a regular check up is mandatory. Too little stomach acid can be just as dangerous as too much, as both these extreme conditions create inflammatory changes in the stomach lining (a condition called chronic atrophic gastritis), which over time leads to cancer. Other risk factors for gastric cancer are a family history of cancer, Helio bacter pylori infection, blood type A, a history of pernicious anaemia and a prior history of gastric polyp. Please get a check up from a gastroenterologist. I AM 57 and underwent two laboratory investigations (different labs) within approx two months. The first test showed up Fasting Blood Sugar of 110 and Post Prandial Blood Sugar of 170. A general physician felt that I might become diabetic in five to six years in view of PPBS. After ruling out the hereditary factor (it does not run in the family) he suggested I control my sugar intake. The second result showed FBS of 98 and PPBS of 142. A different GP felt that it is not possible to predict onset of diabetes. Is it possible to predict the possibility of becoming diabetic? Should I undergo further tests like Glucose Loading test? G.S. UpadyaAnswer: In the absence of strong risk factors like heredity, obesity (increased BMI), high caloric intake, especially more than 25 gm fat intake/day, blood lipid derangement (high cholesterol or triglyceride, low LDL), sedentary lifestyle or smoking, it is difficult to predict the onset of diabetes. Fasting sugar of less than 100 and post-prandial less 140 are taken as normal. Your first lab report puts you in impaired glucose tolerance (IGT) category, of which approximately 10 per cent may develop diabetes subsequently. Therefore, it is imperative to avoid obesity (weight reduction alone can prevent 50 per cent cases) and keep sugar level in the normal range. A full GTT (glucose tolerance test) is also in order. MY son, aged 30, has a habit of grinding his teeth while sleeping. A doctor suggested wearing a teeth-covering device so that the noise is not heard and his teeth won't be damaged. But he does not wear this due to discomfort. Why does grinding teeth develop? Is there any remedy? Name withheldAnswer: Twenty per cent of adults grind their teeth at night. Grinding ("bruxism") is caused by stress and anxiety or an unconscious attempt to smooth out a poor bite. It is a subconscious disorder and many people do not even realise that they are doing it. As the biting force is up to six times greater than pressure during waking hours, significant damage to gums, jaw or teeth can occur. Carefully monitoring and controlling stress can reduce bruxism reduced dramatically. It is recommended to use the mouthpiece at night. Ask your dentist to file down "high spots" (teeth that interfere with a comfortable, aligned bite). Holding a damp warm cloth next to the face for 10 minutes before going to bed helps calm jaw muscles. Meditation also helps. Reduce alcohol (if any) and caffeine consumption. Learn to reduce stress by relaxation techniques. Consult your dentist for more information.IS it good to put few drops of coconut, almond or any oil in a baby's (between 0-3 years) ears/nose/eyes? I have observed a close friend doing this to her daughter, who is now 18 months old. She has been doing this for past one year. I am wondering if this may cause problem to the baby in future. BharathiAnswer: No oil instillation is required in nose/ear or eyes. They may in fact cause damage to eyes by clogging the lachrymal duct or cornea. Instillation of oil in nose is fraught with the risk of inhalation and lipid pneumonia. Common practice of putting oil in ear has no value since natural wax producing glands are sufficient for the purpose. However, in case an insect enters the ear, putting oil will kill the insect and help in removal.