I tried to be health conscious and didn’t like taking drugs, so I attempted natural remedies, including calcium citrate mixed with AbsorbAid. Only the drugs worked.

Then two weeks ago, I stumbled on an article about the benefits of mustard for heartburn. It said to mix 2 teaspoons of mustard with a half glass of water at the first sign of heartburn. I stopped taking Prilosec and tried French’s mustard. I haven’t had heartburn since!

This remedy might not work for everyone, but I hope you let your readers know about it. By the way, I take the mustard as a preventive measure twice a day and, as I said, I have had absolutely no sign of heartburn since.

DEAR READER: There are approximately 40 different varieties of mustard plants; however, there are three basic types — black, white and brown. Prepared mustards commonly consist of ground mustard seed, vinegar, water and flavoring. There’s little to no fat and virtually zero calories. Many varieties included turmeric, a source of curcumin. It’s this ingredient that contains strong anti-inflammatory and antioxidant properties. Mustard seeds are highly renowned for the high amounts of glucosinolates, which are believed to have anticancer properties. They are a good source of iron, magnesium, niacin, phosphorous, calcium, omega-3 fatty acids and zinc.

I am unsure why mustard controls your heartburn, but if it does, stick with it. You can also help your condition by reducing or eliminating alcohol from your diet, avoiding trigger foods such as tomato-based products, carbonated beverages, garlic, onions, citrus products and mint flavorings, incorporating a weight-loss program if appropriate, and elevating the head of your bed four to six inches. Beyond that, it’s good to know that if a person is experiencing symptoms at an inconvenient time, a trip to the refrigerator for the mustard will likely be the answer.

To provide related information on your hiatal hernia, 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 made payable to Newsletter and mailed 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.

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.

Since I have started this I have had no indigestion and have not had to take my Prilosec. I don’t know why or how it works but it does. Please pass this on to your readers.

DEAR READER:
Done. Like, you I have no idea why this would work but am curious to know if it works for others as well.

So readers, if you suffer from gastro-esophageal reflux disease or frequent heartburn and indigestion, please give this remedy a try and let me know what your results were. It is certainly novel, not to mention tasty, but if it works, it could also save a fair amount of money (which is important in these ever-worsening economic times). Bananas are much cheaper and healthful than are medications.

Thanks for sharing and I will be sure to print a follow-up in the future when I have received plenty of responses.

To give you related information, I am sending you a copy of my Health Report “Hiatal Hernia, Acid Reflux and Indigestion”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Can you tell me what causes the spasms, how they could be prevented and what to do when they occur? I know there is a pill I could take but I am not anxious to add another pill to my regimen. I would appreciate any information you can provide on this ongoing problem.

DEAR READER:
Spasms of the esophagus are muscle contractions that prevent food from passing in a normal manner from the esophagus into the stomach.

Symptoms resemble those of gastroesophageal reflux disease (GERD), and can include heartburn, chest pain and more. Contractions can be quite painful, intermittent and vary in intensity with chest pain mimicking angina. Women are more commonly affected by the condition than are men and the probability of the condition increases as an individual ages.

There are a number of steps an individual can take to control symptoms. Diet modification can help. Eliminate or reduce your intake of acidic, greasy/fatty and spicy foods. Try eating four or five smaller meals rather than two or three large ones. You should also avoid foods that are extremely hot or cold as they can trigger an attack.

Short-term treatment may involve an over-the-counter or prescription medication to relax the muscles of the esophagus. Long-term treatment can include the use of additional medications and determining possible underlying health conditions.

Testing by a physician for diagnosis might include the coordination of a barium swallow, esophageal motility test, esophageal computed tomography (CT) scanning, or esophagogastroduodenoscopy. The procedures range from swallowing barium while awake followed by an X-ray technique to having a tube inserted through the mouth and throat while under sedation. Your physician or gastroenterologist is your best resource to determine which procedure is appropriate to determine if any blockages are present and reach a diagnosis.

To give you 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, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I am at a loss as to what could be causing this and my gastroenterologist now wants me to see an ear-nose-and-throat specialist. Do you have any suggestions?

DEAR READER:
A metallic taste in the mouth can be an early sign of vitamin D overdose. Since you don’t say what dosage you take, I cannot be sure if this may be the cause of your problem. Nexium, Forteo and metoclopramide do not list this as a side effect.

Since you have osteoporosis, taking a calcium plus D supplement is recommended. You should be taking 1200-1500 mg of calcium and 400-600 IU of vitamin D daily. Vitamin D can be harmful but only when taken in extremely high amounts, usually over an extended period of time (months or even years), before symptoms are seen.

I believe your gastroenterologist’s referral to an ear-nose-and-throat physician is appropriate. He or she can order testing to determine if there is some correctable abnormality causing the taste perversion.

I would also like to add that metoclopramide is listed for short-term use only in patients who do not respond to conventional GERD treatment (such as Nexium). I could not find a time-frame but this may be something to discuss with your primary care physician or gastroenterologist.

Forteo also has a restricted time-frame for usage. Because of the potential for increased risk of developing a malignant form of bone cancer, the drug has received a black box warning. It should only be used as a last resort for resistant osteoporosis or for individuals who cannot tolerate other medications such as Fosamax and Boniva. Even in this instance, it is not to be taken for more than two years because the risk of side effects increases.

If you are taking the Forteo because of adverse effects from more traditional osteoporosis medication (namely, gastrointestinal upset), I suggest your return to your primary care physician or endocrinologist and ask about the possibility of using the newest form of Boniva which is available as an IV drip. Another option may be the once yearly Reclast injection. Injectable forms of these medications reduce or eliminate the risk of stomach upset and other gastrointestinal side effects.

To give you related information, I am sending you copies of my Health Reports “Osteoporosis” and “Hiatal Hernia, Acid Reflux and Indigestion”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

I read your articles every day and save many of them. Keep up the good work.

DEAR READER:
Barrett’s esophagus is a condition in which the lining of the esophagus is replaced by tissue similar to that of the intestine.

The cause of Barrett’s is unknown. It is three to five times more likely to occur in people with gastroesophageal reflux disease (GERD). The condition itself, however, has no signs or symptoms. Men are affected nearly twice as often as women and Caucasian men are at the top of the list.

Some individuals (less than one percent) with the condition can develop a rare but deadly type of esophageal cancer. The type of cancer associated with Barrett’s esophagus (esophageal adenocarcinoma) is difficult to treat because it is often not found until in the late stages. For this reason, regular examinations, endoscopies and biopsies are necessary. Biopsies can often show precancerous changes which allow for treatment that may prevent further change in the tissue.

Without symptoms, many physicians recommend adults age 40 and older who have had GERD for a number of years undergo endoscopy and biopsy. These are the only tests available for the diagnosis of the condition.

There are a few treatments available for mild to moderate precancerous changes. Photodynamic therapy uses a light-sensitizing agent and a laser to kill the abnormal cells. Endoscopic Mucosal Resection involves lifting the Barrett’s lining and then cutting it off. On occasion, both procedures are performed together. A final option is surgical removal of most of the esophagus. This is only done on individuals with major precancerous changes or full-blown esophageal cancer.

I urge you to return to your gastroenterologist for an explanation of the disorder. He or she is your best resource for information and is the most familiar with your individual case.

If you would like to learn more about Barrett’s esophagus, I recommend you go to the National Digestive Diseases Information Clearinghouse’s website http://digestive.niddk.nih.gov/ddiseases/pubs/barretts or request information by writing to them at 2 Information Way, Bethesda, MD 20892-3576 or by phoning 1-800-891-5389.

To give you related information, I am sending you a copy of my Health Report “Hiatal Hernia, Acid Reflux and Indigestion”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

My question however, doesn’t have to do with the medication. Just before having the DEXA scan, I noticed several enlarged bones in my right foot and ankle. I was tested for Paget’s disease but the results were negative. At my last physical exam, my doctor noticed that my left shoulder blade had enlarged. I have seen several doctors and none can tell me what is causing my bones to enlarge. Do you have any ideas?

DEAR READER:
Because you do not say what type of testing you have had and what types of doctors you have seen I can only give you general suggestions. If these are repeats of what has been done or said, I apologize.

First, I would like to say that I hope along with your Boniva you were told to increase your calcium and vitamin D intake. Boniva and other osteoporosis medications were not designed to treat osteopenia but have been increasingly given to individuals with this pre-osteoporotic condition. If you are not already, I urge you to take 1000-1500 mg of calcium and 600-800 mg of vitamin D daily. This can be achieved through supplements or by increasing your fortified milk, cheese, and yogurt and dark leafy greens intake. Tofu is also often fortified with calcium and vitamin D to round out vegan (no animal products) diets.

Second, I suggest your seek another opinion from an orthopedic specialist who can order testing to determine if you do indeed have Paget’s disease. This condition is defined by abnormal bone break-down and re-growth. The process is sped up in sufferers and often causes bone enlargement. Despite the enlarged bones, they often are weak and brittle which is why Paget’s is often known as “soft bone disease”.

Testing can include X-rays to pinpoint bone enlargement, show re-absorption and other abnormalities. Another valuable test is a bone scan in which a material is injected to show bone better. In Paget’s disease, the affected areas show up darker than healthy, normal bone. A final step is a blood test done to determine the level of alkaline phosphatase. In most individuals with this condition, the levels are elevated. Because I don’t know what testing you have had, I cannot determine if you have had all or some of these.

Treatment for Paget’s disease is similar to that of osteoporosis. It includes biphosphonates such as Fosamax, Boniva and others, and calcitonin. Therapy is aimed at improving bone strength and mineral content.

Therefore, even if you have Paget’s disease, you are already receiving proper care; however, you need to have a diagnosis. If you don’t have Paget’s disease after having thorough testing, you need to know why you are having spontaneous bone enlargement. Ask your primary care physician for a referral to an orthopedic specialist and go from there.

To give you related information, I am sending you a copy of my Health Report “Osteoporosis”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

DEAR READER:
There are numerous ways of dealing with this condition. You can place blocks under the legs at the head of your bed; modify your diet to avoid spicy foods that trigger an attack; or take an over-the-counter medication such as Prilosec or TUMS.

Perhaps as a first step, the blocks, coupled with the Prevacid you are presently taking, will reduce or eliminate the phlegm. If not and you remain dissatisfied, speak with your pharmacist for a suggestion on the best remedy he carries. Should that fail, return to your physician for a change to another prescription medication that might eliminate the cough. Also, you might consider a consultation with a gastroenterologist.

To give you related information, I am sending you a copy of my Health Report “Hiatal Hernia, Acid Reflux and Indigestion. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I have had a scope and upper GI done, both of which were normal. I have a known hiatal hernia and ulcer. I’ve been on Prevacid 30 mg daily for acid reflux disease that seems to help sometimes, but not always. Maybe you can help me figure out what is wrong and why I feel this way.

DEAR READER:
Let me start by saying that your scope and upper GI could not have been normal if you have an ulcer and a hiatal hernia.

Hiatal hernia refers to a defect in the middle of the diaphragm (the muscle that allows the foods we eat to leave the esophagus and enter the stomach). Rather than keeping the stomach in place, the defect allows it to slip through into the esophagus. Severe cases result in heartburn, indigestion, belching, bloating, nausea, chest pain and difficulty swallowing. Similar symptoms also present in people with acid reflux disease.

An ulcer is the result of stomach acid wearing a hole in the lining of the stomach. It can be very painful and may cause internal bleeding.

Your 18-year smoking habit can positively cause (or worsen) your symptoms. Kick the habit for a month or two and if no progress has been made, return to your doctor to determine if he will provide a stronger prescription medication for symptom control. Following that, a referral to a gastroenterologist is in order.

To give you related information, I am sending you a copy of my Health Report “Hiatal Hernia, Acid Reflux and Indigestion”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

I can’t say that I am losing weight very quickly, but I certainly don’t miss the heartburn. I also feel a whole lot healthier than before. Perhaps others have noticed this unexpected (yet pleasant) side effect as well.

We now plan to purchase your cook book to add more variety to our stock of recipes. Thank you for such a wonderful and easy to follow diet.

DEAR READER:
Congratulations on starting (and sticking with) my diet. As you have noticed, weight will not drop as drastically as it does on fad/crash diets. This means your weight loss is much more healthful and requires you to work toward goals. Soon, this way of eating will be more a lifestyle choice than a diet.

As for your reduction in acid indigestion, I can only assume it is due to a more balanced diet and a reduction in processed, fatty foods. Most people believe that excess stomach acid, indigestion and heartburn are the result of spicy or acidic foods. In some cases, this is true, but for the most part, highly processed and/or fatty foods are the real culprit. I am sure most gastroenterologists would agree that simply cutting out excess fatty/greasy foods could “cure” the problem for many sufferers.

I hope you and your husband stick with my diet and continue to feel better and reach your weight goals.

To give you related information, I am sending you my newly updated Health Report “Hiatal Hernia, Acid Reflux and Indigestion”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.