THIS week I share three questions from readers, all regarding abdominal complaints. As always, my advice is in line with currently agreed guidelines, but cannot be a substitute for consulting with your own doctor.

Question – I went for an ultrasound scan for urine infections. The scan showed that I was passing urine normally, but they found a large gallstone. My GP said it was nothing to worry about – Andrea, 51

Answer – Things are often found on scans that perhaps you were not expecting. If you randomly scanned several people, some would have gallstones. Of that group, not all would have symptoms of gallbladder disease.

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A larger gallstone is of less worry. Whereas this will likely stay in the gallbladder, smaller stones may slip down the bile duct and into the pancreatic duct. If a stone gets lodged here, it may cause pancreatitis, which can be life threatening.

If you are not getting any pain, and your GP is satisfied with your scan, I would be inclined to leave it. However, if you do develop symptoms, this would be a reason for a referral to a general surgeon.

Question – I have a hiatus hernia. When I press on my breastbone at the bottom, I can feel a lump. Is this it? – Andrew, 53

Answer – The oesophagus (gullet) becomes the stomach when it passes through a hole in the diaphragm.A hiatus hernia occurs when a portion of the stomach goes through this hole and enters the chest cavity.

The main issue is that the oesophagus and stomach are no longer separated, and acidic contents of the stomach wash up the gullet, causing heartburn.

While the stomach is designed to cope with acidic contents, the oesophagus is not, and uncontrolled acid is a risk factor for the development of oesophageal cancer.

In most cases, a hiatus hernia is managed by acid reducing tablets.

You cannot feel a hiatus hernia, as it is inside the body cavity. The tip of the sternum (breastbone) can be felt at top of your abdomen.

Question – I have been put on Lansoprazole by my GP, after complaining of acid. I read that there is a risk of osteoporosis and pneumonia with these tablets. My mother had a hip fracture after a fall, and it has always been at the back of my mind. Jean, 71

Answer – There is a slightly increased risk of osteoporosis and pneumonia with regular and/or high dose acid reducing tablets known as Proton Pump Inhibitors (PPI). The most prescribed ones are lansoprazole and omeprazole.

However, this must be balanced against the long-term risk of excess acid on the lining of the oesophagus (gullet). The greatest concern is the development of oesophageal cancer.

The risk factors for osteoporosis are menopause before 45, smoking, excess alcohol, being underweight and deficient in calcium and vitamin D.