Dear Dr. Garner,
I hope you can help me. I have an embarrassing problem. I am constantly burping. Sometimes I get severe pain.
Could I have GERD? What should I do? Should I see my doctor?
Bloated in Belle Harbor
Dear Bloated,
The time to see your doctor is when your problem interferes with everyday activities. It sounds like you have reached this point so a visit to the doctor is in order.
When there is buildup of gas in your stomach and intestines, it can cause bloating and pain. It may be aggravated by fatty foods, carbonated drinks, eating too quickly, stress or smoking. Some common food culprits that produce excess gas include: beans, broccoli, sprouts, cabbage, cauliflower, chewing gum, hard candies, milk, onions and whole grain foods. When you belch, it is your body’s way of expelling extra air from the stomach. Some people swallow air as a nervous habit.
To reduce belching:
- Eat and drink slowly.
- Avoid carbonated drinks and beer.
- Skip gum and hard candy.
- Don’t smoke.
- Check your dentures. Poorly fitting dentures can cause you to swallow excess air when eating and drinking.
- Treat any mild heartburn using over-the-counter medications.
Gastroesophageal reflux disease (GERD) occurs when there is severe reflux (regurgitation). When someone has regurgitation, some of the contents of the stomach leak back into the food pipe (esophagus). It is considered GERD if the reflux causes severe frequent heartburn that affects the quality of life. There may be burning in the throat, bad taste in the mouth or nausea.
People who have GERD often feel very full all of the time. GERD can cause a cough and loss of tooth enamel. It can cause chest pains, laryngitis and even asthma. Most people can manage the pain from GERD with lifestyle changes (losing weight, not smoking and exercise). Over-the-counter medications may be very helpful.
Symptoms play a key role in the diagnosis of GERD. Questions that should be answered include:
- How often do you have discomfort?
- Do symptoms appear after eating or when the stomach is empty?
- Do symptoms get worse when you lay down?
The goal of treatment is to relieve symptoms such as heartburn. Medications known as proton pump inhibitors, such as Prilosec, reduce the production of stomach acid by inhibiting a certain enzyme. They can relieve typical symptoms of heartburn. Other medications, like Zantac, work by preventing a large amount of stomach juice from being made by blocking the action of the hormone histamine in the stomach.
Antacids might be an option if someone has mild heartburn or can’t tolerate the medications mentioned earlier.
If medication doesn’t work, surgery may be an appropriate option. The aim of anti-reflux surgery is to prevent stomach acid from flowing back into the esophagus. Research has shown that anti-reflux surgery may be more effective at relieving symptoms than medication. You are at increased risk for GERD if you are: pregnant, a smoker, an asthmatic, have diabetes or suffer from dry mouth. Make sure to review the case with your doctor.
Measles Vaccine
Before signing off, I want to stress how crucial it is to get your children vaccinated for diseases such as measles. The federal Centers for Disease Control is extremely concerned about measles. A growing number of kindergarten students are not vaccinated in the U.S.
Parents choose not to vaccinate for a variety of reasons, some because of misinformation regarding autism and vaccines. There are extremely severe complications from measles and it is a highly contagious disease. Get your family vaccinated. It may save a life!
Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET TV, Tuesdays at 8 p.m. on Time Warner Channel 97, Cablevision Channel 30 and Verizon FiOS on Demand.
