Dear Dr. Gott: Is there any home remedy for GERD? I am on Zegerid, watch what I eat, have the head of my bed elevated, and still can't get rid of the midsternal indigestion. I have had a thorough medical workup.

Reply: Gastroesophageal reflux disease is acid reflux that occurs regularly. The ring of muscles that separates the stomach from the oesophagus is either weak or fails to close properly. Symptoms present when the backwash of stomach acid enters the oesophagus and, as you are likely aware, can include difficulty swallowing, chest pain, a burning sensation, pain, dry cough, bad breath and more.

Treatment is one of progression. Over-the-counter medications such as Prilosec, Tagamet or Pepcid AC might be considered; when ineffective, they may be followed by prescription medication.

Then might come X-ray testing, such as a barium swallow or upper endoscopy, which should reveal whether your symptoms are from GERD or caused by something else. If your GERD is severe and caused by a hiatal hernia, surgical repair may be recommended. Hiatal hernias can develop from sudden physical exertion, straining during evacuation, vomiting or coughing.

Other than the modifications you have already tried, I might suggest weight loss and discontinuing smoking if you are overweight or smoke, eating several smaller meals throughout the day, wearing loose-fitting clothing, and allowing adequate time for proper digestion by not lying down for about three hours after eating.

Home remedies abound and include eating an apple or part of one, drinking diluted apple-cider vinegar, eating lemons or almonds, or sipping small amounts of chilled fat-free milk or water every one to two hours.

No one thing works for everyone, but a trial might be appropriate if you are willing to go out on a limb.

I'm even told different apples help for different people.

Zegerid is a combination of omeprazole and sodium bicarbonate for your stomach acid. You might consider returning to your physician to request an alternative medication that could provide better results, or request a referral to a gastroenterologist for a second opinion and other possible options.

To provide related information, I am sending you a copy of my Health Report 'Hiatal Hernia, Acid Reflux and Indigestion'. Other readers who would like a copy should send a self-addressed stamped number ten envelope and a $2 cheque or money order to Newsletter, PO Box 167, Wickliffe, Ohio 44092.

Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Dear Dr. Gott: I'm having RSD with lots of pain. Do you know any doctors who work with this problem?

Reply: Reflex Sympathetic Dystrophy (RSD), today more commonly known as Complex Regional Pain Syndrome, is thought to be a chronic pain dysfunction of the central or peripheral nervous system.

No single cause is known; rather, multiple causes appear to produce similar symptoms.

Triggers can include infection, injury, heart disease, degenerative arthritis of the neck, stroke, thyroid disorders, shingles, specific medications and more. There is no specific blood or diagnostic test for confirmation. Treatment consists of physical therapy, exercise, medication, spinal-cord stimulation and more.

Trials of Botox are even being considered for pain control.

I suggest you join a local support group or contact the RSDSA at PO Box 502, Milford, Connecticut 06460; (877) 662-7727; info@RSDS.org.

Dr. Peter Gott is a retired physician and the author of 'Dr. Gott's No Flour, No Sugar Diet' and 'Dr. Gott's No Flour, No Sugar Cookbook'. Contact him c/o United Media, 200 Madison Avenue, fourth floor, New York, New York 10016.