Should I squelch the belch?
Dear Lucy: Many years ago, I developed the ability to belch on cue. I still can, but rarely demonstrate it. Now I have acid reflux disease. Could the two be related? —Urrrrppp
Dear Urrrrppp: Lucy finds herself strangely fascinated by your unique gift. Though not the sort of talent one would exhibit every day, Lucy is quite sure there are situations wherein the ability to belch on cue would be ever so useful. But to find out if this form of self expression might also lead to problems with acid reflux, Lucy sought out a man who knows about such things, MIT Medical gastroenterologist Richard Gardner, M.D.
Though Gardner declined to comment on the potential social perils of voluntary belching, he did say that the practice carries no physical risks and is not associated with acid reflux disease. "Gastroesophageal reflux disease, or GERD, occurs when frequent relaxation or weakness of the lower esophageal sphincter, a muscular valve at the junction of the esophagus and stomach, allows stomach contents to leak back, or reflux, into the esophagus," he explained. "In contrast, voluntary belching occurs when one swallows air, and then deliberately forces the air back out by contracting the abdominal muscles and relaxing the upper esophageal sphincter, which is in the throat area."
Belching can occur as a result of lower-sphincter weakness, Gardner notes, but in such cases, the air released is from the stomach, and the belching is spontaneous and involuntary.
According to Gardner, although your burping is not to blame, a number of other factors are associated with the onset of acid reflux disease, including the development of a hiatal hernia. Small hiatal hernias are relatively common in otherwise healthy people over age 50. Acid reflux may also be associated with weight gain. Your primary care provider should be able to suggest lifestyle changes and/or medications to help you control troublesome symptoms. —Lucy
top
Tummy rumblings
Dear Lucy: I have a three-year old niece who often gets upset stomachs. I don't know what causes them, but she cries every time she gets one. Whenever she falls asleep on an upset stomach, I'll put my hand on her stomach and feel it gurgling. Sometimes the gurgling is loud and long. Do you know anything that could help her out? —Concerned Auntie
Dear Auntie: It's wonderful to hear from a caring aunt like you. Lucy is sure all the adults around your young niece are equally concerned about her frequent tummy upsets. For help with this question, Lucy spoke with Pat Bartels, A.P.R.N., B.C., a pediatric nurse practitioner here at MIT Medical.
Bartels tells Lucy that stomach noises—the medical term is "borborigme"—are not, in and of themselves, cause for concern. "Most stomachs make some noise as food and drink are digested," Bartels says, "and some make more noise than others."
However, Bartels emphasizes, a child who frequently complains of an upset stomach should be evaluated. "Sometimes a small child is urged to eat too much and ends up over full," she notes. "Sometimes there is a problem with the digestion of certain foods. An 'upset tummy' can also be a way for a child to say he or she is unhappy about something."
Bartels advises that in the week or two before your niece sees her clinician, your niece's parents should keep a sort of "diary," writing down what the child eats or drinks, noting the times she says her tummy is upset, and specifying where she says it hurts. "The dietary history is key in making a diagnosis," Bartels notes. "The child's pediatrician or nurse practitioner will also ask about the family's mealtime routines," she adds.
Good luck getting to the bottom of this problem with the help of your child's healthcare provider. —Lucy
top
