Doctor's Diary: In medicine, less can be more A new kind of Nerd The Eighties film Revenge of the Nerds ("Time for the odd to get even"") presciently anticipated that this pejorative term for the socially inept would become in time a badge of honour - particularly for those who have prospered from mastering the intricacies of information technology. For those delving into the intricacies of the human body, "Nerd" has a rather different connotation - the proposed explanation for why the lining of the oesophagus in those with severe heartburn is not, as might be expected, angry and inflamed - but rather appears entirely normal. Such patients are now labelled as having Non-Erosive Reflux Disease, which, claims Dr Philip Woodland of St Bart's Hospital in this month's issue of the journal Gut, is due to an "impairment of mucosal integrity"" that makes them more sensitive to acid reflux without overt evidence of damage. The same situation may occur in the stomach, where despite the characteristic ulcer symptoms of severe epigastric pain after meals, there is no evidence of an ulcer on endoscopy. The treatments of both these enigmatic conditions is gratefully straightforward - by using acid-suppressant drugs such as omeprazole. Multi-purpose multivitamins Further to the account by a woman gratified, if puzzled, that the Prozac prescribed for her menopausal hot flushes should also have cured her painful arthritic joints, another reader described something similar after deciding "on a whim"" to take her husband's Multivitality 70+ capsules - which claim to provide "a perfect blend of 30 essential elements for everyone over the age of 70"." She had for years been troubled by arthritis in the thumb and wrist, "such that I could not do the ironing or lift a frying pan"." Within a fortnight she was vastly better and, wondering whether this might be coincidence, discontinued the capsules, only for her original symptoms to occur. These resolved on taking them again. "I have no idea which 'essential element" might be responsible as there are so many," she writes. But I certainly intend to carrying on taking them. A spot of bother This week's medical query comes courtesy of Mrs R M from Bristol, who suspects the sore pimples that have erupted on her nose over the past couple of years are caused by drinking wine. "It is killing my social life having to turn down a glass of rosé on a summer's evening," she writes. Has anyone had a similar experience, and what might be done about it? James Le Fanu's online clinic returns on September 20; telegraph.co.uk/health