Ask the Doctor: March 2007

Question: I am a 57-year old male and have just started to get heartburn over the last few months. I was wondering, should I be concerned about anything more serious?

Answer: Heartburn is a very common problem and usually easily treated by diet, lifestyle changes and/or medications. However, there are some signs that should prompt you to see a doctor and be evaluated with an EGD (stomach scope). In your case, one of those factors is that you are over 55 years old.

Other “red flag” signs and symptoms are unexplained weight loss, persistent vomiting or vomiting blood, painful swallowing, and a feeling of being full after only a small amount of food. If you are using NSAIDs such as ibuprofen or naproxen, you should also tell your doctor. These signs and symptoms are concerning for ulcers, esophageal cancer, stomach cancer, or esophageal stricture, and you should be evaluated as soon as possible.

Question: Is there a way to “cure” athlete’s foot? I have recurring bouts and am not sure what to do to stop it.

Answer: Chronic athlete’s foot is difficult to treat but can be cured. However, if untreated, it can persist indefinitely. Over the counter creams are the standard treatment and will work, but you have to use them consistently for four weeks. If you don’t improve with the topical treatments, you can see your doctor for an oral medication. If you also have a fungal toenail infection, you should be treated with oral medications; topical will not work for you. In addition, treating your shoes with foot powder can help. You should also make sure that you get rid of any shoes you wear without socks (including your flip-flops you wear in the gym shower) because the athlete’s foot can live there.

Question: At what age should I have my skin examined for any signs of skin cancer? I am 32 but have not noticed any changes in my skin or any moles.

Answer: The current recommendations suggest that high risk people have yearly skin checks by a physician, with careful attention to the skin between checks, and evaluations sooner if moles change. However, the US Preventative Task Force guidelines do not suggest an age at which to start screening.

High risk patients include patients with fair skin, over the age of 65, a personal history of atypical moles or previous skin cancer diagnosis, or more than 50 moles on their body. Patients who do not fall into these groups should monitor their own skin for warning signs of skin cancer and seek evaluation for biopsy as soon as possible. The ABCDs of melanoma are: Asymmetry of the mole, Border irregularity, Color variability, or Diameter greater than 6mm (about the size of a pencil eraser).

Dr. Karen D. Lockwood is board-certified in Internal Medicine and is currently in private practice in Troy, MI.

If you would like to submit a medical question to Dr. Lockwood, please email your question to: askthedoc@healthandleisureonline.com

*Advice found within this article is for information purposes only and should not replace the advice orrecommendations of your physician.