Ask the Doctor: Gastric sleeve surgery, acid reflux and dementia, macular degeneration

Doctor Rob Riley joins us from Memorial Family Medicine every Tuesday to answer viewer questions.

Here are the questions he addressed during NewsCenter 16 at Noon on February 16, 2016:

Mike: What are some of the pros and cons of gastric sleeve surgery?

Dr. Riley: Gastric sleeve surgery is one of the surgical options for the treatment of severe obesity. In this surgery, a good portion of the stomach is removed, usually through a scope. The upsides are that this surgery can be effective in causing significant weight loss when more usual methods have not been successful. The downsides are that this is still a surgery and there are risks for serious complications, particularly in obese people, including infections and leakage from the surgical site, as well as some eating problems which may be permanent. In general, surgical options are sort of a last resort, but may offer success when usual methods have failed.

Question: I've been taking Nexium for two years for acid reflux. Dementia already runs in my family. Should I stop taking it?

Dr. Riley: Nexium is in a class of drugs called proton pump inhibitors which work by reducing stomach acid. There was a recent study in Germany, though, suggesting that long-term use of these medications may be associated with the development of dementia, and that has some people worried. It's important to note, though, that this was a single study that's not been reproduced anywhere yet. And while the study suggests an association, that's not the same as showing that the drug actually increases the risk of developing dementia. So, there will be more studies coming. In the meantime, I always advise people to work with their doctors to be on the least amount of medication necessary for the shortest time possible.

Question: What's the difference between wet and dry macular degeneration?

Dr. Riley: In general, macular degeneration is a condition we see most often in the elderly which can lead to a significant loss of vision, even blindness. As the viewer suggests, this condition comes in two flavors referred to as "wet" or "dry." Dry macular degeneration results from a thinning of the tissue on the back of the eye called the retina. While it's more common than the wet type, the consequences are usually less serious. Wet type results from abnormal blood vessels growing into the retina and then leaking. This can cause a much more rapid and damaging loss of vision. In fact about 80-90% of the blindness caused by macular degeneration is caused by the wet type. Fortunately, effective treatment is available for both types.

If you have medical questions, you can call the health professionals at Memorial Hospital.