DEAR DR. ROACH: I am 80 years old, still work full-time and have generally good health, except for adult-onset asthma. Advair 250/50 was prescribed for me over 10 years ago, and I've been taking it regularly each morning, thoroughly rinsing each time to prevent thrush. About five years ago, I developed an abdominal hernia just below my waistline. My primary physician referred me to a general surgeon, who did a very thorough exam, including an MRI from the jaw down. He discovered an esophageal hernia in addition to the abdominal hernia, and told me that a specialist would have to perform the double surgery. His advice was to avoid surgery, leaving it as a last resort. He prescribed famotidine twice daily to preclude acid reflux. That generally works, but not always.

My question is, does Advair 250/50 cause or contribute to an esophageal hernia? — D.A.A.

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