Why do I suffer from terrible acid reflux every morning and what can I do about it? DR ELLIE has the answer

I suffer with acid reflux but only in the morning. What could be the cause?

Experiencing acid reflux in the morning is very common.

Acid reflux, commonly known as heartburn, occurs when stomach acid rises into the oesophagus – the pipe that connects the digestive system to the throat. This can trigger a burning pain in the chest, a sour or bitter taste in the mouth, regurgitation of food or fluid and nausea.

The problem is often triggered by poor diet – typically fatty or sugary food or drink – as well as smoking, drinking and consuming too much coffee.

For many, the problem can feel worse in the morning, because, during the night, while the body is horizontal, the stomach acid can rise into your oesophagus. This can be even more pronounced if sufferers eat just before sleeping.

There are over-the-counter antacid tablets available that can reduce the symptoms. Or GPs can prescribe stronger proton pump inhibitors such as omeprazole – however, these cannot fix the problem in the long run and overuse can damage the stomach lining and even the bones.

Anyone struggling with reflux early in the day should consider eating earlier in the evening, and, when in bed, prop up their head with a pillow – gravity can help to prevent stomach acid from rising. However, reflux that goes on for a few weeks should always be checked by a GP, as in rare cases it can be a sign of cancer.

I am 78 and had an MRI scan on my brain after a fall. It found that I have mild white matter disease. Should I be worried?

It’s normal for people over the age of 60 to have this.

White matter disease – also known as leukoaraiosis – is a term used to describe damage to the brain’s white matter, which contains nerve fibres that help different parts of the brain communicate with each other.

It is typically caused by reduced blood flow to small vessels in the brain. These changes have been shown to raise the risk of strokes and dementia in the future.

However, more than half of over-60s have this form of visible brain damage, and most have no symptoms.

It’s only a problem if accompanied with symptoms.

So anyone who experiences memory problems, slowness in tasks and mood changes such as depression should talk to their GP, as these could be signs of dementia.

White matter disease cannot be reversed, but there are steps that can be taken to stop it from worsening. These include lowering cholesterol levels and by making healthy diet choices.

Regular exercise as well as cutting out alcohol and smoking will also help.

Have you been hit by scabies?

We’re apparently in the middle of yet another scabies outbreak – though I don’t feel it has ever gone away.

Last week it was reported there had been a sharp rise in cases noted by the Royal College of General Practitioners’ Research and Surveillance Centre. But I would say most weeks I speak to sufferers, and often families, with scabies.

The mite infestation is spread through skin-to-skin contact, sharing beds and holding hands, and the big problem nowadays is treatment.

Permethrin lotion no longer works due to resistance, and yet that is what many people are still given. The UK Health Security Agency changed guidance last April to include a better product called ivermectin but it isn’t being given widely.

Have you had treatment for scabies that didn’t help? Write to me and let me know.

It’s not just women at risk from brittle bones 

Last week in Health we raised the serious issue of osteopenia – the bone-thinning stage that precedes full-blown osteoporosis – and how many women remain unaware and undiagnosed.

But what about men? Bone thinning is still widely treated as a women’s health issue, largely because risk rises sharply after the menopause. As a result, men are often overlooked.

Many assume they are protected, or that brittle bones and fractures are simply an inevitable part of ageing and nothing can be done.

In reality, early diagnosis matters. Treatments and simple lifestyle changes can slow bone loss and significantly reduce the risk of catastrophic fractures later on. Too often, men are only diagnosed after suffering a serious break, when the damage has already been done.

The problem is this: I can’t remember the last time I referred a man for a diagnostic bone scan – known as a DEXA scan – or even discussed bone thinning with a male patient.

Official data suggest that almost seven per cent of men in the UK over 50 may have osteoporosis, yet they are far less likely than women to receive a diagnosis or treatment.

If you are a man who has been diagnosed with osteopenia or osteoporosis – or only discovered the problem after a fracture – I want to hear from you. Please write to me using the email address below.

Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk. Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.