FROM OUR EXPERTS
Inhaled steroids (IS) for the treatment of asthma have become a standard in the U.S. and many countries around the world. They are an essential cornerstone in the management of persistent asthma. Adverse effects of IS are minimal, but a small percentage of patients may experience dysphonia (hoarseness, weakness or loss of voice), throat irritation, cough or candida overgrowth (oral thrush).
Many patients who have hoarseness related to IS describe a subtle onset which began months or years after starting the inhaler. There is increased risk of voice change with higher doses or strengths of inhaled steroid. It’s often very frustrating when you have established a good routine of daily inhalations and have reaped the rewards of good asthma control, but later learn the wonder drug is weakening your voice.
Studies have reported between 10-50% of patients on IS experience hoarseness, although package inserts only reflect a range of 1-8%. In my practice it always seems to be a singer,...
My doctor has recommended that I have my hiatal hernia repaired. I am waiting to see a surgeon. Is this a good idea, and what should I ask the surgeon?
Although rarely necessary, at times, surgical repair of a hiatal hernia is the right choice in patients with gastroesophageal reflux disease . There are two types of hiatal hernia. In the much more common, sliding hernia, in which the stomach slides below the esophagus into the chest, medical therapy usually is very effective. The paraesophageal hernia, in which the stomach herniates next to the esophagus, is usually managed surgery. This is because of the potentially life-threatening complication of strangulation. When surgery is considered, it is best to see a surgeon that performs the procedure laparoscopically, if it is possible. Laparoscopic anti-reflux surgery involves reinforcing the valve between the esophagus and the stomach by wrapping the upper portion of the stomach around the lowest portion of the esophagus. Using on...
Heartburn, also known as gastric reflux or indigestion, happens after you eat and food is in your stomach. In the stomach, food is broken down by acids. Usually these acids stay in your stomach because a valve blocks the acids from going up the esophagus. Sometimes this valve doesn't work properly because the muscle weakens. When this happens, gastric acids can travel up the esophagus and cause a burning sensation -- this is heartburn. When these acids travel up into the mouth and then down into the lungs, they can cause gastroesophageal reflux disease (GERD).
Symptoms of heartburn and GERD include:
irritating burning sensation in the chest or throat
middle back pain
bitter, acidic taste in the mouth
an increase in the burning sensation while lying down
Breast cancer treatments that can cause heartburn and GERD are:
Tykerb (chemical name: lapatinib), a targeted therapy
Bisphosphonates, medicines that are used to protect bones during breast cancer treat...
You should know
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