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Health Matters: Providence St. Jude Medical Center | 5 Q: I was told I may have acid reflux. Can you explain what causes acid reflux and how I can control it? A: Acid reflux is very common and occurs when there is weakness in the lower esophageal sphincter (a circular band of muscle that controls food traveling down toward your stomach). Normally, the valve closes tightly after food enters the stomach. If it relaxes when it shouldn't, stomach contents flow backwards, causing reflux. Heartburn is a common symptom of acid reflux, as are bloating, sore throat, nausea after eating and regurgitation that produces a sour or bitter taste. For mild acid reflux, a few lifestyle modifications may help reduce your symptoms. Try avoiding or limiting fatty and spicy foods, tomatoes, onions, mint, garlic, coffee and alcohol. Eat meals in moderation and slowly. You should also wait a few hours after eating before attempting vigorous exercise. Eating dinner several hours before going to bed and elevating your head while you sleep can reduce symptoms. You can also try over-the-counter medications including antacids, such as Tums or Maalox, and H-2-receptor blockers like cimetidine (Tagamet HB) or famotidine (Pepcid AC). If lifestyle changes and over-the-counter medications are not providing lasting relief, call your doctor. Serious acid reflux symptoms—including blood in your vomit, difficulty swallowing, unexpected weight loss, long-lasting nausea, chronic sore throat, wheezing or dry throat—should be evaluated by a physician immediately. Notify your physician if you have chronic acid reflux symptoms that occur at least twice a week, as this can be a symptom of gastroesophageal reflux disorder, or GERD. Q: My four-year-old son has been a picky eater for several years. I'm worried he's not getting the nutrients he needs. When should I be concerned? A: "Picky eating" is very common and impacts most children and even some adults. It usually begins when a child is one or two years old. It can last for a few years, but children typically outgrow this phase between ages three and five. During this time, many parents worry that their child is not getting enough nutrients to support their growth and development. Nutritional deficiency from picky eating is very rare. Even in the most extreme cases, your child is likely getting enough nutrients and calories to stay healthy. There is no need to be anxious about picky eating if your son has a few "off' days but generally consumes a variety of nutritional foods throughout the week and is gaining weight. Journaling his diet over an extended period of time can paint a bigger picture of his eating habits and help ease your fears. If he has fallen behind on the growth chart and is exhibiting irritability or attention issues and low energy, it may be time to bring in reinforcements. An underlying difficulty could be the reason behind his choosy eating. He may have a phobia of certain foods or the digestion process, such as a fear of choking while swallowing. Refluxes and allergies may be causing him discomfort or pain while eating. A physician can partner with you and your child to address any of these causes in a controlled, therapeutic and positive environment. Christine Vu, DO, is a family medicine physician with St. Jude Heritage Medical Group, at the Brea Medical Office. Her areas of interest include women's health, diabetes, hypertension and skin disorders. She believes in partnering with her patients to aid in their health and wellness. Dr. Vu is accepting new patients and is located at 955 W. Imperial Hwy., in Brea. Call 714-449-6900 to make an appointment. Vince R. Cacho, MD, is board-certified in pediatrics and internal medicine with St. Jude Heritage Medical Group in Chino Hills. He has more than 14 years of experience providing personalized care to patients through all stages of life, from pediatrics to adulthood. Dr. Cacho's office is located at 15855 Pomona Rincon Road in Chino Hills. To schedule an appointment, visit Providence.org/chinohills.

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