Acid reflux

Heartburn drugs may increase a user's risk of pneumonia.

* THE QUESTION The stomach acids that can cause pain and upset also act as a barrier to disease-causing organisms. Does taking antacids to reduce these gastric juices increase a person's chances of developing a viral or bacterial disease such as pneumonia?

* THIS STUDY examined the medical records over a three-year period of about 365,000 current or former users of acid-suppressing drugs. People taking acid suppressants at the start of the study were more likely to contract pneumonia than those who had stopped using them. This additional risk was greater forthose taking proton pump inhibitors (such as Nexium, Prevacid and Prilosec) than for histamine blockers (such as Tagamet, Pepcid and Zantac). The risk increased when more than one dose was taken daily.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People who take drugs for heartburn, whether caused by indigestion or gastroesophageal reflux disease.

* CAVEATS The study was not randomized.

* BOTTOM LINE People at risk for pneumonia -- including older people and those with asthma, chronic lung disease or immune disorders -- may want to talk with their doctor before taking antacids for extended periods.

* FIND THIS STUDY Oct. 27 issue of the Journal of the American Medical Association; abstract available online at www.jama.com.

* LEARN MORE ABOUT indigestion and gastroesophageal reflux at http://digestive.niddk.nih.gov and www.mayoclinic.com.

dizziness

Head and eye exercises seem to help people retain balance.

* THE QUESTION People who have repeated dizzy spells may take drugs or just wait for the symptoms to go away on their own. Might exercises that retrain the body to compensate for the loss of balance offer another option?

* THIS STUDY randomly assigned 170 adults with chronic dizziness to either continue their regular care or be given vestibular rehabilitation, a series of simple head and eye exercises to stimulate the vestibular system, which controls balance. Participants in the exercise group had one half-hour session with a nurse who taught them how to do the exercises and gave them a booklet to use when exercising daily at home. Six months later, 67 percent of the exercisers reported less dizziness and more stability, compared with 38 percent of the others. At the start of the study, all participants said moving their head made them dizzy. At the end of the study, 23 percent of the exercisers were free of that symptom, compared with 6 percent of the others.

* WHO MAY BE AFFECTED BY THESE FINDINGS? People with chronic dizziness. Balance disorders, which can have a myriad of causes, become more common as people age.

* CAVEATS Participants knew whether they had received the treatment being tested. Results were based on self-reporting by the participants. It is unclear whether the same results would be achieved by people less diligent about performing the exercises.

* BOTTOM LINE People with chronic dizziness may want to talk with their doctor about vestibular rehabilitation.

* FIND THIS STUDY October issue of the Annals of Internal Medicine; abstract available online at www.annals.org.

* LEARN MORE ABOUT dizziness and balance disorders at www.nidcd.nih.gov and www.mayoclinic.com.

obsessive-compulsive disorder

Talk therapy with drugs may help fight repetitive urges.

* THE QUESTION Both drugs and psychotherapy can help quell the severe repetitive behaviors of obsessive-compulsive disorder (OCD), such as the urge to wash your hands over and over. Might these treatments be more effective if used together?

* THIS STUDY randomly assigned 112 young people, 7 to 17 years old and diagnosed with OCD, to get one of four types of treatment: a daily dose of the antidepressant Zoloft (sertraline), weekly psychotherapy sessions aimed at changing their thought and behavior patterns, a combination of medication and therapy, or a placebo. After 12 weeks, 54 percent of those treated with both Zoloft and therapy had their symptoms under control, compared with 39 percent who got only the therapy, 21 percent who took just the drug and 4 percent of the placebo group.

* WHO MAY BE AFFECTED BY THESE FINDINGS? Young people with OCD. The disorder, which affects about 3 percent of Americans, usually begins in adolescence.

* CAVEATS Whether the same results would be achieved with less-skilled therapists is unknown. Antidepressants have been associated with an increased risk of teen suicide; this study, however, reported no such effects. Drugs were provided by Pfizer, maker of Zoloft. Two of the authors have received fees from Pfizer.

* BOTTOM LINE Parents of children with OCD may want to ask a doctor about combining drugs and psychotherapy.

* FIND THIS STUDY Oct. 27 issue of the Journal of the American Medical Association; abstract available online at www.jama.com.

* LEARN MORE ABOUT OCD at www.kidshealth.org and at www.adaa.org.

-- Linda Searing