Ask the Doctor: GERD, Restless Legs Syndrome and migraines

Dr. Rob Riley joins us each week from the South Bend Clinic. Here are his responses from May 7.

Seth: I have a severe case of GERD and do not understand it. I still suffer taking Prilosec and Zantac.

GERD is an acronym for gastroesophageal reflux disease. That sounds kinda scary but it just means the normal stomach acid that’s supposed to stay in the stomach is sometimes coming back up into the esophagus or swallowing tube. This can cause heartburn pain and a sour taste in the mouth. The first line of medical treatment is medications that reduce stomach acid like Prilosec and Zantac our viewer mentioned. Other things that help are elevating the head of the bed at night and avoiding things that make reflux worse like alcohol, nicotine, and caffeine. Typically, this approach is effective, but when it’s not, it’s usually a good idea to pass a scope down the throat and into the stomach to take a look around and make sure there isn’t something else causing the symptoms. Fortunately, only rarely is surgery needed.

Art and Kim: My legs seem restless most nights. I have to rub them for a while before I can get to sleep. What can I do for this?

People with Restless Legs Syndrome have this uncomfortable urge to move their legs during times of inactivity such as when they’re trying to go to sleep at night. That discomfort is relieved temporarily by moving the legs, but it comes right back. We don’t really know what causes this but it’s pretty common, affected about 5-10 per cent of people at some time in their lives. People with low iron levels and pregnant women are particularly at risk. And some medications, including over the counter antihistamines, can make things worse. Things which seem to help are iron supplementation for those with low iron levels, regular exercise, and reducing caffeine intake. If that approach isn’t effective, there are some medications that are typically used for people with Parkinson’s Disease that are helpful for people with Restless Legs.

Linda: Is it possible to have the visual auras without getting a migraine?

Absolutely. What used to be called classic migraine starts with some sort of sensory disturbance, often a bright or shimmering area in the visual field which passes and is followed by a typical migraine headache. Many people who have this kind of migraine will sometimes have this visual aura and not get the headache and there are even a few people who get the aura and never have the headache. Auras can just be a minor nuisance, but if they’re big enough, they can interfere enough with normal vision to interfere with a person’s daily activities. We don’t precisely know what causes auras or migraine headaches, but both are felt to be part of the same phenomenon in the brain. So for those who need treatment for aura alone, we typically use the same medications we use to treat migraine to help.