No chance for successful ectopic pregnancy

DEAR DR. ROACH » What is an ectopic pregnancy?

ANSWER » “Ectopic” comes from the Greek roots meaning “out of place,” and that’s just what it is. A normal pregnancy is in the uterus (also called “womb”). The most common places for an ectopic pregnancy are along the path the ovum (egg) travels, meaning from the ovary, through the fallopian tube (which carries the ovum from the ovary to the uterus) and the uterus, and even its opening, the cervix.

Rates from 0.6% to 2% of pregnancies are reported as being ectopic. Rates are higher in Black women and women who were older when pregnant. There is virtually no chance for a successful ectopic pregnancy, and there’s a high risk to the mother’s life. So as early as possible, ectopic pregnancies are treated to avoid rupture of the tube. Both surgical and medical therapies are available.

I recently was diagnosed with diffuse esophageal spasm (DES). Upon initiating any meal, I begin to cough continuously. It may last for the first minute or two of the meal and then

DEAR DR. ROACH »

seems to subside. I do have heartburn at times as well. The doctor diagnosed based on my symptoms without diagnostic testing. My physician suggested an old-school medication called Tagamet. These symptoms are embarrassing and are affecting my lifestyle. I don’t even want to sit down with family or friends to eat because of this constant initial coughing. Can you shed some information on this condition? I am a 62-year-old female. I am 125 pounds. I take losartan and a cholesterol medication.

— CP ANSWER » Without definitive testing (done by measuring the pressures in the esophagus), I can’t be sure you have this diagnosis. Gastroesophageal reflux disease, where stomach acid goes into the esophagus, is a much more common entity to cause heartburn and cough (this can be complicated because GERD is a common trigger for DES). Cimetidine (Tagamet) blocks some acid production and is a good (if old) treatment for GERD. It tends not to be as effective as proton pump inhibitors like omeprazole. If you aren’t getting relief, I’d recommend consultation with a gastroenterologist.