For kid’s sake, seek second opinion

Dear Dr. Gott: My 5-year-old child has a peptic ulcer and has been taking Zantac once a day for four months now. Her pediatrician wants her to remain on the medication for another three months, after which he said he would scope her and do a biopsy, as he does not want to do another upper GI series. Is a biopsy the only method available to determine if the ulcer still remains? How long should she remain on the Zantac, as I’m concerned about the long-term effects of having an ulcer at such an early age?

Dear Reader: As you have read, many (if not all) ulcer patients may suffer from a bacterial infection (H. pylori) that causes the disorder.

Peptic ulcers are very uncommon in children but, if your daughter has H. pylori infection, she could be cured by using special antibiotics for 10 to 14 days This condition can be diagnosed by a blood test.

I shouldn’t disagree with a specialist outside my area of practice, which is general internal medicine, but endoscopy in a 5-year-old is an uncomfortable and expensive procedure that is best avoided, if possible.

Therefore, I recommend that you seek a second opinion from a gastroenterologist. There may be more appropriate options than endoscopy/biopsy.

In any case, the biopsy isn’t to see if the ulcer remains; it is to sample the tissue to see if a growth is the basis for the ulcer. The gastroenterologist can advise you.

In addition, you should ask the specialist about the use of Zantac, an anti-ulcer medicine, in children. According to the manufacturer, the safety and effectiveness of the drug in the pediatric population has not been established.

To give you related information, I am sending you a copy of my Health Report “Peptic Ulcers.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: My doctor has suggested that I apply 1 percent hydrocortisone cream to my legs nightly because of poor circulation. Is this too much cortisone, since I cover my legs completely?

Dear Reader: This makes no sense to me. Hydrocortisone cream is not going to affect circulation. The only effect you’re likely to see is reduced inflammation and scaling of the skin of your legs.

But you may pay a price even for this meager benefit. With this amount of skin covered, you are certainly going to absorb a significant quantity of cortisone into your body, leading to potential complications such as diabetes, brittle bones and susceptibility to infection.

If your circulation is impaired, you may fare better by stopping smoking, exercising more regularly, elevating your legs when possible, using elastic support hose -– and seeing a vascular surgeon for advice about whether an operation might benefit you.