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.