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Contents

Considerations

Causes

Home Care

When to Contact a Medical Professional

What to Expect at Your Office Visit

 

Belching is the act of bringing up air from the stomach.

Considerations

Belching is most often a normal process. The purpose of belching is to release air from the stomach. Every time you swallow, you also swallow air, along with fluid or food.

The buildup of air in the upper stomach causes the stomach to stretch. This triggers the muscle at the lower end of the esophagus (the tube that runs from your mouth to the stomach) to relax. Air is allowed to escape up the esophagus and out the mouth.

Depending on the cause, belching may last longer or be more forceful.

Symptoms such as nausea, dyspepsia, and heartburn may be relieved by belching.

Causes

Belching may be due to:

·       Pressure caused by the unconscious swallowing of air (aerophasia)

·       Acid reflux disease (GERD) and heartburn

Home Care

You can get relief by lying on your side or in a knee-to-chest position until the gas passes.

Avoid chewing gum, eating quickly, and eating gas-producing foods and beverages.

When to Contact a Medical Professional

Most of the time belching is a minor problem. Call a health care provider if the belching does not go away, or if you also have other symptoms.

What to Expect at Your Office Visit

Your provider will examine you and ask questions about your medical history and symptoms, including:

·       Is this the first time this has occurred?

·       Is there a pattern to your belching? For example, does it happen when you are nervous or after you have been consuming certain foods or drinks?

·       What other symptoms do you have?

You may need more tests based on what the provider finds during your exam and your other symptoms.

 

Source: https://medlineplus.gov/ency/article/003080.htm

Contents

Causes

Symptoms

Exams and Tests

Treatment

When to Contact a Medical Professional

 

Difficulty with swallowing is the feeling that food or liquid is stuck in the throat or at any point before the food enters the stomach. This problem is also called dysphagia.

Causes

The process of swallowing involves several steps. These include

·       Chewing food

·       Moving it into the back of the mouth

·       Moving it down the esophagus (the tube that moves food to the stomach)

There are many nerves that help the muscles of the mouth, throat, and esophagus work together. Much of swallowing occurs without you being aware of what you are doing.

A brain or nerve disorder can alter the workings of the muscles of the mouth and throat.

Swallowing is a complex act. Many nerves work in a fine balance to control how the muscles of the mouth, throat, and esophagus work together.

A brain or nerve disorder can alter this fine balance in the muscles of the mouth and throat.

·       Damage to the brain may be caused by multiple sclerosis, Parkinson disease, or stroke.

·       Nerve damage may be due to spinal cord injuries, amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease), or myasthenia gravis.

Stress or anxiety may cause some people to feel tightness in the throat, or feel as if something is stuck in the throat. This sensation is unrelated to eating and is called globus hystericus.

Problems that involve the esophagus often cause swallowing problems. These may include:

·       An abnormal ring of tissue that forms where the esophagus and stomach meet (called Schatzki's ring)

·       Abnormal spasms of the esophagus muscles

·       Cancer of the esophagus

·       Failure of the muscle ring at the bottom of the esophagus to relax (Achalasia)

·       Scarring that narrows the esophagus. This may be due to radiation, chemicals, medicines, chronic swelling, ulcers, or infection.

·       Something stuck in the esophagus, such as a piece of food.

·       Scleroderma, a disorder in which the immune system mistakenly attacks the esophagus

·       Tumors in the chest that press on the esophagus

Symptoms

Chest pain, the feeling of food stuck in the throat, or heaviness or pressure in the neck or upper or lower chest may be present.

Other symptoms may include:

·       Cough or wheezing that becomes worse

·       Coughing up food that has not been digested

·       Heartburn

·       Nausea

·       Sour taste in the mouth

You may have problems swallowing with any eating or drinking, or only with certain types of foods or liquids. Difficulty eating very hot or cold foods, dry crackers or bread, meat, or chicken may be an early sign of swallowing problems.

Exams and Tests

Your health care provider will order tests to look for:

·       Something that is blocking or narrowing the esophagus

·       Problems with the muscles

·       Changes in the lining of the esophagus

A test called upper endoscopy (EGD) is often done.

·       An endoscope is a flexible tube with a light on the end. It is inserted through the mouth and down through the esophagus to the stomach.

·       You will be given a sedative and will feel no pain.

Other tests may include:

·       Barium swallow and other swallowing tests

·       Chest x-ray

·       Esophageal pH monitoring (measures acid in the esophagus)

·       Esophageal manometry (measures pressure in the esophagus)

·       Neck x-ray

You may also need to have blood tests to look for disorders that could cause swallowing problems.

Treatment

The treatment for your swallowing problem depends on the cause.

It is important to learn how to eat and drink safely. Incorrect swallowing may lead to choking or breathing food or liquid into your main airway. This can lead to pneumonia.

To manage swallowing problems at home:

·       Your provider may suggest changes to your diet. You may also get a special liquid diet to help you stay healthy.

·       You may need to learn new chewing and swallowing techniques.

Medicines that may be used depend on the cause, and may include:

·       Certain medicines that relax the muscles in the esophagus. These include nitrates, which is a type of medicine used to treat blood pressure, and dicyclomine.

·       Injection of botulinum toxin.

·       Medicines to treat heartburn and gastroesophageal reflux (GERD).

·       Medicines to treat an anxiety disorder, if present.

Procedures and surgeries that may be used include:

·       Upper endoscopy: The provider can dilate or widen a narrowed area of your esophagus using this procedure. For some people, this needs to be done again, and sometimes more than once.

·       Radiation or surgery: These treatments may be used if cancer is causing the swallowing problem. Achalasia or spasms of the esophagus may also respond to surgery.

If your symptoms are severe and you are unable to eat and drink enough, or you have problems choking or pneumonia, you may need a feeding tube.

When to Contact a Medical Professional

Call your provider if swallowing problems do not improve after a few days, or they come and go.

Call your provider right away if:

·       You have a fever or shortness of breath.

·       You are losing weight.

·       Your swallowing problems are getting worse.

·       You cough or vomit up blood.

·       You have asthma that is becoming worse.

·       You feel as if you are choking during or after eating or drinking.

 

Source https://medlineplus.gov/ency/article/007543.htm

Contents

Causes

Home Care

When to Contact a Medical Professional

What to Expect at Your Office Visit

 

Heartburn is a painful burning feeling just below or behind the breastbone. Most of the time it comes from the esophagus. The pain often rises in your chest from your stomach. It may also spread to your neck or throat.

Causes

Almost everyone has heartburn sometimes. If you have heartburn very often, you may have gastroesophageal reflux disease (GERD).

Normally when food or liquid enters your stomach, a band of muscle at the end of your esophagus closes off the esophagus. This band is called the lower esophageal sphincter (LES). If this band does not close tightly enough, food or stomach acid can back up (reflux) into the esophagus. The stomach contents can irritate the esophagus and cause heartburn and other symptoms.

Heartburn is more likely if you have a hiatal hernia. A hiatal hernia is a conditions which occurs when the top part of the stomach pokes into the chest cavity. This weakens the LES so that it is easier for acid to back up from the stomach into the esophagus.

Pregnancy and many medicines can bring on heartburn or make it worse.

Medicines that can cause heartburn include:

·       Anticholinergics (used for sea sickness)

·       Beta-blockers for high blood pressure or heart disease

·       Calcium channel blockers for high blood pressure

·       Dopamine-like drugs for Parkinson disease

·       Progestin for abnormal menstrual bleeding or birth control

·       Sedatives for anxiety or sleep problems (insomnia)

·       Theophylline (for asthma or other lung diseases)

·       Tricyclic antidepressants

Talk to your health care provider if you think one of your medicines may be causing heartburn. Never change or stop taking medicine without talking to your provider first.

Home Care

You should treat heartburn because reflux can damage the lining of your esophagus. This can cause serious problems over time. Changing your habits can be helpful in preventing heartburn and other symptoms of GERD.

The following tips will help you avoid heartburn and other GERD symptoms. Talk to your provider if you are still bothered by heartburn after trying these steps.

First, avoid foods and drinks that can trigger reflux, such as:

·       Alcohol

·       Caffeine

·       Carbonated drinks

·       Chocolate

·       Citrus fruits and juices

·       Peppermint and spearmint

·       Spicy or fatty foods, full-fat dairy products

·       Tomatoes and tomato sauces

Next, try changing your eating habits:

·       Avoid bending over or exercising just after eating.

·       Avoid eating within 3 to 4 hours of bedtime. Lying down with a full stomach causes the stomach contents to press harder against the lower esophageal sphincter (LES).

·       Eat smaller meals.

Make other lifestyle changes as needed:

·       Avoid tight-fitting belts or clothes that are snug around the waist. These items can squeeze the stomach, and may force food to reflux.

·       Lose weight if you are overweight. Obesity increases pressure in the stomach. This pressure can push the stomach contents into the esophagus. In some cases, GERD symptoms go away after an overweight person loses 10 to 15 pounds (4.5 to 6.75 kilograms).

·       Sleep with your head raised about 6 inches (15 centimeters). Sleeping with the head higher than the stomach helps prevent digested food from backing up into the esophagus. Place books, bricks, or blocks under the legs at the head of your bed. You can also use a wedge-shaped pillow under your mattress. Sleeping on extra pillows does NOT work well for relieving heartburn because you can slip off the pillows during the night.

·       Stop smoking. Chemicals in cigarette smoke weaken the LES.

·       Reduce stress. Try yoga, tai chi, or meditation to help relax.

If you still do not have full relief, try over-the-counter medicines:

·       Antacids, like Maalox, Mylanta, or Tums help neutralize stomach acid.

·       H2 blockers, like Pepcid AC, Tagamet, and Zantac, reduce stomach acid production.

·       Proton pump inhibitors, like Prilosec OTC, stop nearly all stomach acid production.

When to Contact a Medical Professional

Get urgent medical care if:

·       You vomit material that is bloody or looks like coffee grounds.

·       Your stools are black (like tar) or maroon.

·       You have a burning feeling and a squeezing, crushing, or pressure in your chest. Sometimes people who think they have heartburn are having a heart attack.

Call your health care provider if:

·       You have heartburn often or it does not go away after a few weeks of self-care.

·       You lose weight that you did not want to lose.

·       You have trouble swallowing (food feels stuck as it goes down).

·       You have a cough or wheezing that does not go away.

·       Your symptoms get worse with antacids, H2 blockers, or other treatments.

You think one of your medicines may be causing heartburn. DO NOT change or stop taking your medicine on your own.

What to Expect at Your Office Visit

Heartburn is easy to diagnose from your symptoms in most cases. Sometimes, heartburn can be confused with another stomach problem called dyspepsia. If the diagnosis is unclear, you may be sent to a doctor called a gastroenterologist for more testing.

First, your provider will do a physical exam and ask questions about your heartburn, such as:

·       When did it begin?

·       How long does each episode last?

·       Is this the first time you have had heartburn?

·       What do you usually eat at each meal? Before you feel heartburn, have you eaten a spicy or fatty meal?

·       Do you drink a lot of coffee, other drinks with caffeine, or alcohol? Do you smoke?

·       Do you wear clothing that is tight in the chest or belly?

·       Do you also have pain in the chest, jaw, arm, or somewhere else?

·       What medicines are you taking?

·       Have you vomited blood or black material?

·       Do you have blood in your stools?

·       Do you have black, tarry stools?

·       Are there other symptoms with your heartburn?

You may need the following tests:

·       Esophageal motility to measure the pressure of your LES

·       Esophagogastroduodenoscopy (upper endoscopy) to look at the inside lining of your esophagus and stomach

·       Upper GI series

If your symptoms do not get better with home care, you may need to take medicine to reduce acid that is stronger than over-the-counter medicines. Any sign of bleeding will need more testing and treatment.

 

Source: https://medlineplus.gov/ency/article/003114.htm

Contents

Considerations

Causes

Home Care

When to Contact a Medical Professional

What to Expect at Your Office Visit

 

Belching is the act of bringing up air from the stomach.

Considerations

Belching is most often a normal process. The purpose of belching is to release air from the stomach. Every time you swallow, you also swallow air, along with fluid or food.

The buildup of air in the upper stomach causes the stomach to stretch. This triggers the muscle at the lower end of the esophagus (the tube that runs from your mouth to the stomach) to relax. Air is allowed to escape up the esophagus and out the mouth.

Depending on the cause, belching may last longer or be more forceful.

Symptoms such as nausea, dyspepsia, and heartburn may be relieved by belching.

Causes

Belching may be due to:

·         Pressure caused by the unconscious swallowing of air (aerophasia)

·         Acid reflux disease (GERD) and heartburn

Home Care

You can get relief by lying on your side or in a knee-to-chest position until the gas passes.

Avoid chewing gum, eating quickly, and eating gas-producing foods and beverages.

When to Contact a Medical Professional

Most of the time belching is a minor problem. Call a health care provider if the belching does not go away, or if you also have other symptoms.

What to Expect at Your Office Visit

Your provider will examine you and ask questions about your medical history and symptoms, including:

·         Is this the first time this has occurred?

·         Is there a pattern to your belching? For example, does it happen when you are nervous or after you have been consuming certain foods or drinks?

·         What other symptoms do you have?

You may need more tests based on what the provider finds during your exam and your other symptoms.

 

Source: https://medlineplus.gov/ency/article/003080.htm