Patients often have questions about the duration and implications of medications like omeprazole, seek guidance on complex conditions such as Functional Neurological Disorder (FND), or want proactive strategies for managing seasonal allergies. Dr. Martin Scurr provides expert insights into these common health concerns.

Regarding the prolonged use of proton pump inhibitors (PPIs) such as omeprazole, many patients are prescribed these medications for extended periods beyond the typical maximum of one month. PPIs reduce stomach acid production and are commonly used to treat acid reflux, preventing damage to the oesophagus lining and lowering the risk of conditions like Barrett’s oesophagus, which can increase cancer risk. They are also prescribed for patients taking corticosteroids to mitigate side effects such as gastritis or ulcers.

While the benefits are significant, they must be weighed against potential risks. Short-term side effects of omeprazole can include headaches, abdominal pain, flatulence, nausea, and bowel upset. Long-term use may lead to lower absorption of essential nutrients like vitamin B12, magnesium, iron, and calcium, since stomach acid plays a crucial role in their uptake. This deficiency can result in symptoms such as tremors, tingling, and muscle cramps from low magnesium, and may even contribute to rare kidney damage known as interstitial nephritis. Although evidence regarding cardiovascular risks is mixed, Dr. Scurr advises annual reviews for patients on PPIs, including blood tests to monitor kidney function, magnesium, vitamin B12, and iron levels.

Another area of concern is Functional Neurological Disorder (FND), a challenging and often misunderstood condition. FND arises from a disruption in how the brain sends and receives information, akin to “computer software going haywire.” Patients may experience what appear to be epileptic convulsions but do not respond to anticonvulsant medications. Diagnosis follows extensive testing—such as electroencephalograms, cerebrospinal fluid sampling, or video telemetry—to definitively rule out neurological disease.

Once diagnosed, psychiatric care is crucial. A psychiatrist can help the patient understand that their symptoms, although real, are triggered by the subconscious mind rather than neurological disease. This does not mean the condition is imaginary; rather, it highlights the importance of specialized psychological support. Psychotherapy is often the most appropriate treatment to manage symptoms and address underlying triggers.

For individuals significantly affected by seasonal allergies, Dr. Scurr emphasizes proactive preparation, noting that late autumn is the ideal time to get ready for spring allergens such as birch pollen (February/March) and grass pollen (April/May). A key treatment option is oral immunotherapy (OIT), a method that has existed for over a century but has recently gained prominence for various allergies, including food allergens.

OIT works by gradually exposing the allergic person to small, controlled doses of their specific allergen, training the body to become desensitized. While widely used internationally for seasonal allergies and administered as a daily sublingual pill, its availability on the NHS can be limited. However, it is often accessible privately through prescribing pharmacists. OIT is effective not only for pollen but also for other allergens such as dogs, horses, and house dust mites, typically requiring daily treatment over three consecutive hay fever seasons for lasting immune retraining.