DEAR READER: Gastroesophageal reflux disease occurs when the muscle that separates the stomach from the esophagus fails to close properly or is weakened, allowing a backwash of stomach acid into the esophagus. Hiatal hernia occurs as a result of increased abdominal pressure caused by sudden physical exertion, vomiting, coughing, obesity, increased abdominal pressure and excess fluid in the abdomen.

A small 2002 study of 18 women over the age of 65 reported the concomitant use of omeprazole with calcium carbonate when taken without food decreased calcium absorption in elderly women. It contradicted a study a few years earlier from Tufts in which omeprazole was found not to interfere with calcium, zinc or phosphorous absorption.

The medication your physician recommended is to reduce the amount of acid produced. Common symptoms of GERD include chest, neck and arm pain, breathing difficulties, dry cough, difficulty swallowing, burning or pressure and bad breath. Debilitating stomach cramps and vomiting are uncommon. Speak with your physician to rule out other possible causes or health conditions and to determine whether you should continue or discontinue the omeprazole. Then request a referral to a gastroenterologist for further testing if appropriate.

To provide related information, I am sending you a copy of my Health Report “Hiatal Hernia, Acid Reflux & Indigestion.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.