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Ask the doctors

Q. I heard that the FDA recently issued a warning related to a specific treatment for Clostridium difficile infections. Can you explain what this warning is about?

A. The FDA issued a warning in June aimed at health care providers who are using fecal transplants to treat Clostridium difficile (C. difficile) infections that have not responded to traditional treatments, such as antibiotics. Doctors perform fecal transplants (which are still considered investigational by the FDA) by introducing stool from a healthy donor into the gastrointestinal tract of the person infected with C. difficile. The introduction of healthful bacteria can sometimes treat the infection, which typically inflames the colon causing symptoms such as severe diarrhea, cramps, and fever. The FDA issued its warning after two immunocompromised adults developed infections from an antibiotic-resistant strain of Escherichia coli (E. coli) following transplants from stool contaminated with the bacteria. Both people got transplants from the same donor. One of the two people died following the infection. To prevent similar problems in the future, the FDA now recommends that doctors performing these transplants follow some new safety measures, including the following:

Excess gas can be annoying, but is it cause for concern?

Gas is a normal � yet embarrassing � part of digestion. "We're all pretty gassy as individuals," says Dr. Kyle Staller, a gastroenterologist with Harvard-affiliated Massachusetts General Hospital.

In fact, the average person produces between 1/2 and 1 liter of gas every day and passes gas about 10 to 20 times. "While people may not like it when they do it, especially at inappropriate times, it's just a sign of a regular, healthy digestive system at work," says Dr. Staller.

Q.ÌýI've been taking Prilosec for many years for GERD. Recently, I once read that long-term use of proton pump inhibitors could increase the risk of stomach cancer. Your opinion?

A.ÌýPrilosec is a pump inhibitor (PPI). These drugs have revolutionized the treatment of gastroesophageal reflux disease (GERD), in which stomach acid flows back into the esophagus and causes heartburn.

Q.ÌýI belch a lot and get a feeling of fullness in the upper abdomen. Is excessive belching Ìýa common condition? What are the causes and cures? I would prefer natural remedies.

A.ÌýBelching and feeling full are normal, everyday experiences. So, what makes them "excessive"? There's no precise definition. But if you start belching or feeling full more often than you have in the past, or if belching and fullness are causing you distress and discomfort, then I'd consider that excessive belching and a problem that you should try to solve.

Ask the doctor

Q. I think I have heartburn, but I hear that what feels like heartburn is sometimes a more serious condition. How do I know if I have heartburn?

A. You've asked an important question. "Heartburn" describes symptoms caused by the reflux of stomach acid up into the esophagus (the tube that carries food from the mouth down to the stomach). It is a burning sensation. You can feel it high in the abdomen, just below the bottom of the breastbone, or underneath the middle of the breastbone in the chest. In other words, despite the word "heart" in the word "heartburn," real heartburn comes not from the heart, but from the stomach and esophagus.

Q.ÌýI have read that people who have had their gallbladders removed should take bile salts. My gallbladder was removed many years ago, and no doctor has said I should take bile salts. Should I?

A.ÌýBile salts are produced in the liver, secreted into the bile ducts and gallbladder, and sent from there to the small intestine by way of the common bile duct. In the intestine, bile salts make it easier for your body to absorb and digest the fats and fat-soluble vitamins that you've eaten. Remember, not all fats are bad: there are "good" fats, and they are crucial to our health.

Sales of cannabidiol-infused products are expected to top $2 billion by 2021. But is CBD right for you?

Cannabidiol (CBD) is touted as a natural wonder that can help treat symptoms of everything from anxiety to arthritis pain. The plant extract comes from two varieties of cannabis � hemp and marijuana � and is available in creams, tinctures, oils, patches, gummy bears, capsules, and more. You can even add CBD to a latte if you walk into a coffee shop in some cities.

But is CBD safe for older adults? There haven't been a lot of large studies of CBD's safety, but more traditional medicines for pain and anxiety are not free of adverse effects, either. "I think CBD is likely safer than many other treatments people use for pain, insomnia, or anxiety," says Dr. Peter Grinspoon, a primary care physician with Harvard-affiliated Massachusetts General Hospital. Other physicians don't think we know enough about the safety profile of CBD to be sure.

But these remedies aren't the best choice if you have frequent heartburn.

You feel the familiar sensation in your chest: heartburn. Again, you find yourself reaching for the bottle of antacids in the medicine cabinet. It's something you've done a few times a week for the past six months. Is it okay to keep popping over-the-counter acid reducers, or is it time to see a doctor?

We asked two experts, Dr. Jennifer Nayor and Dr. Molly Linn Perencevich, both instructors in medicine at Harvard Medical School, for their thoughts on heartburn, including when it's okay to use over-the-counter antacids and when you should seek other treatments. Below are their responses.