NATIONAL GERD AWARENESS WEEK 17 - 23 NOVEMBER 2020

Easy Ways to Tame Excessive Gas everydayhealth.com Jun 6, 2017 9:30 PM Excessive gas can be embarrassing and uncomfortable. Here are seven easy steps that may help.  To most effectively reduce excessive gas, first find out what is causing it. There are a lot of ways to describe excessive gas: burping, belching, flatulence, and bloating. While what you call it might not seem to matter, being able to identify where the gas starts — and where it ends — can help you treat the painful or embarrassing symptoms. For example, burping and belching usually refer to gas that escapes from the mouth, while flatulence, or farting, is intestinal gas that escapes from the rectum. Bloating is used to describe the sensation of excess stomach gas that has not yet been released. It’s common to experience some gas after eating — and to release it through belching or flatulence. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), passing gas about 13 to 21 times a day is normal. But if you’re experiencing painful gas and the embarrassment of chronic and foul smelling flatulence, you can start to play detective and try to eliminate the cause with the following steps. 1. Avoid Foods Known to Cause Gas One way to manage flatulence and belching is to eat fewer of the well-known gassy foods. Common culprits include: certain fruits, like apples and pears; specific vegetables, such as broccoli, Brussels sprouts, and onions; whole grains like bran; and dairy products, including milk, cheese, and ice cream. These items contain fiber, sugars, and starches that don't digest or absorb easily, eventually causing intestinal gas. Foods containing sorbitol, a naturally occurring sugar found in fruit, are on some people’s gassy foods list. Other people are bothered by carbonated soft drinks and fruit drinks. If you discover that these foods are causing you excess gas, eliminate them from your diet or eat them in small portions. When it comes to foods to avoid, moderation is key, says Stephen Bickston, MD, professor of internal medicine and director of the inflammatory bowel disease program at the Center for Digestive Health at Virginia Commonwealth University in Richmond. Keep in mind that almost any food or combination of foods can cause gas. “Certain foods don’t get along well in certain people,” says Donald Novey, MD, an integrative medicine physician in Poulsbo, Washington. “Some people find they are gassy if they eat fruits with proteins, or if they eat starches and proteins together. It’s personal and requires a little experimentation to find out what the culprits are.” Dr. Novey suggests keeping a food diary and noting when you feel gassy. “If you find you’re gassy after eating a certain food, eliminate it from your diet and see if it helps," he says. Cooking may help break down some of the offending ingredients, Dr. Bickston says. “But the style of cooking can also decrease healthy chemicals found in vegetables. Boiling seems to break down chlorophyll and other desirable ingredients.” Look for recipes that call for steaming, as that seems to be a better cooking method for gassy foods. 2. Drink Before Meals If you drink liquids with your meals, you lose stomach acids and can’t break down food as well, Novey says. Try drinking about 30 minutes before a meal to help your stomach digest better. 3. Eat and Drink Slowly When you eat or drink fast, you can swallow a lot of air, which can cause gas, says Bickston. The simple solution? Slow down when you eat. If you have dentures, check with your dentist to be sure they fit properly so you’re not gasping air while eating. 4. Take Over-the-Counter Digestive Aids Digestive enzymes are available as over-the-counter supplements. “I recommend going to the health food store and getting a digestive enzyme,” says Novey. “You can take one or two. You will know very rapidly — within a few weeks — if it makes a difference.” But antacids won’t do much for excessive gas, says Bickston. Another over-the-counter digestive aid, Beano, contains an enzyme that breaks down the complex carbohydrates in beans and many vegetables into more easily digestible sugars. Take two to three Beano tablets or one Beano Meltaway (a dissolving tablet) before each meal. Note that Beano won't help if excessive gas is caused by fiber or lactose. 5. Try Activated Charcoal Activated charcoal may help reduce and treat excess gas and bloating. Unlike the charcoal you find in your grill or fireplace, activated charcoal undergoes a special treatment that makes it safe for human consumption. Once you take activated charcoal (via liquid or pill), it attaches to fluid in your gut, potentially reducing gas and bloating and creating firmer stools. 6. Don't Fill Up on Air Habits like smoking, chewing gum, and drinking through a straw may cause your stomach to fill with air, leading to gas. 7. Avoid Artificial Sweeteners Sorbitol and related sugar alcohols used in many sugar-free versions of foods can also aggravate gas. “Sorbitol is often the first ingredient in any brand of sugar-free gum I’ve found at local grocery stores,” says Bickston. “One to two sticks is akin to eating a prune.” But the sugar substitutes that are found at a typical coffee stand or in popular soft drinks are not the kind that cause gas. The various packet sweeteners — yellow (sucralose), pink (saccharine), and blue (aspartame) — are not associated with gas or laxative effects. When Gas Is a Symptom of Something Else If excessive gas is persistent or severe, consult your doctor — it could be a sign of a more serious digestive condition, such as: Lactose Intolerance This is the inability to digest lactose, the sugar found in milk and milk products. “I test with a milk challenge,” says Bickston. “The patient drinks a pint or two of milk — it can be any percent fat. What follows tells the patients whether they should limit their milk intake.” If avoiding milk reduces your symptoms you may be lactose intolerant.Irritable Bowel Syndrome (IBS) “Patients who meet the diagnostic checklist for irritable bowel syndrome suffer more pain at the lower levels of the abdominal cavity,” he says.Colon Cancer “Excess gas is rarely the main symptom of patients with colon cancer,” Bickston notes. “But it does trigger my reflex to remind patients to get screened for colorectal cancer.”Upper Gastrointestinal Disorders Occasional belching is normal, but frequent belching may be a sign of an upper gastrointestinal disorder. These include peptic ulcers, gastroesophageal reflux disease (GERD), or gastroparesis, also called delayed gastric emptying. Also, warns Bickston, if you've had abdominal surgery, a hernia, or significant weight loss or weight gain, never dismiss your gas-like symptoms as normal. Get them checked out. As annoying as it might be, some gas is a natural byproduct of the body’s digestive system. But if your gas is excessive, painful, or chronic, talk to your doctor about possible causes and remedies.

Friends today I am discussing about Heartburn. What is heartburn? Despite its name, heartburn doesn’t affect the heart. Heartburn is a burning feeling in the lower chest, along with a sour or bitter taste in the throat and mouth. It usually occurs after eating a big meal or while lying down. The feeling can last for a few minutes or a few hours. Symptoms of heartburn Heartburn symptoms vary. They may be slight or extreme. The severity of heartburn may depend on what you have eaten and how much you have eaten. The main symptom of heartburn is a burning feeling in your throat and chest. This happens when when the acidic liquid from your food or drink comes back up into your esophagus. You may have difficulty swallowing or choke on this acid. It may even make you hoarse or cough. What causes heartburn? When you eat, food passes from your mouth down a tube called the esophagus. The esophagus is about 10 inches long in most people. To enter the stomach, the food must pass through an opening between the esophagus and stomach. This opening acts like a gate to allow food to pass into the stomach. Usually, this opening closes as soon as food passes through. But if it doesn’t close all the way, acid from your stomach can get through the opening and into your esophagus. This is called reflux. Stomach acid can irritate the esophagus and cause heartburn. Hiatal hernia can also cause heartburn. Hiatal hernia is a condition in which part of the stomach is pushed up through the diaphragm (the muscle wall between the stomach and chest) and into the chest. Sometimes this causes heartburn. How is heartburn diagnosed? You probably do not need a doctor to diagnose heartburn. Heartburn symptoms are easy to recognize. And there are many over-the-counter medicines to help manage symptoms. If you are questioning whether you have heartburn, you should ask your doctor. He or she will likely be able to diagnose you based on your symptoms. Can heartburn be prevented or avoided? You might be able to avoid heartburn by making some changes in your lifestyle. Tips for preventing heartburn include: Place 6- to 9-inch blocks under the legs at the head of your bed to raise it. Try to eat at least 2 to 3 hours before lying down. If you take naps, try sleeping in a chair. If you smoke, quit. Lose weight if you’re overweight. Don’t overeat. Eat high-protein, low-fat meals. Avoid tight clothes and tight belts. Avoid foods and other things that give you heartburn. Things that can make heartburn worse Many things can make heartburn worse. Heartburn is most common after overeating, when bending over or when lying down. Pregnancy, stress, and certain foods can also make heartburn worse. Things that can make heartburn worse: Cigarette smoking. Coffee (both regular and decaffeinated) and other drinks that contain caffeine. Alcohol. Carbonated drinks. Citrus fruits. Tomato products. Chocolate, mints, or peppermints. Fatty foods or spicy foods (such as pizza, chili, and curry). Onions. Lying down too soon after eating. Being overweight or obese. Aspirin or ibuprofen (one brand name: Motrin). Certain medicines (such as sedatives and some medicines for high blood pressure). Heartburn treatment If lifestyle changes and antacids don’t help your symptoms, talk with your doctor. Your doctor may want you to take prescription medicine. Or he or she may schedule you for some tests. Tests might include: pH test to check for acid in the esophagus. Endoscopy to check for other conditions. During an endoscopy, your doctor looks into your stomach through a long, thin tube. This tube is inserted down your esophagus. Your doctor may also check for pylori, bacteria that can cause ulcers. What about medicines for heartburn? Several kinds of medicine can be used to treat heartburn. Antacids neutralize the acid that your stomach makes. For most people, antacids that you can get without a prescription (over-the-counter) give fast, short-term relief. However, if you use antacids too much, they can cause diarrhea or constipation. Look for antacids that contain both magnesium hydroxide and aluminum hydroxide. One causes constipation while the other causes diarrhea. So they counteract each other. Some brands of antacids include Maalox, Mylanta, and Riopan. Follow the directions on the package. H2 blockers (some brand names: Pepcid, Tagamet, Zantac) reduce the amount of acid your stomach makes. Several are available without a prescription. Other medicines, such as omeprazole (brand name: Prilosec) and lansoprazole (brand name: Prevacid), also reduce how much acid the stomach makes. Metoclopramide (brand name: Reglan) reduces acid reflux. To find out what medicine is right for you, talk with your doctor. Can heartburn be serious? If you have heartburn only now and then, it’s probably not serious. However, if you have heartburn frequently, it can lead to esophagitis (an inflamed lining of the esophagus). If esophagitis becomes severe, your esophagus might narrow. This can cause bleeding or trouble swallowing. If you get more than occasional heartburn, it may be a symptom of something more serious. It could mean that you have: acid reflux disease gastroesophageal reflux disease (GERD) an inflamed stomach lining (gastritis) hiatal hernia peptic ulcer. Living with heartburn Sometimes pain in the chest may be mistaken for heartburn when it’s really a sign of heart disease. If you have any of the symptoms below, call your doctor. You have trouble swallowing or pain when swallowing. You’re vomiting blood. Your stools are bloody or black. You’re short of breath. You’re dizzy or lightheaded. You have pain going into your neck and shoulder. You break out in a sweat when you have pain in your chest. You have pain when you exercise. You have heartburn often (more than 3 times a week) for more than 2 weeks. Primary Homoeopathic Remedies Carbo vegetabilis This remedy relieves bloating and gas in the stomach, with belching. Lycopodium This remedy relieves discomfort and indigestion, with bloating around the waist and gas, especially after eating onions or garlic. Natrum carbonicum This remedy can be helpful to mild people who have trouble digesting and assimilating many foods and have to stay on restricted diets. Indigestion, heartburn, and ulcers can occur if offending foods are eaten. Milk or dairy products can lead to flatulence or sputtery diarrhea that leaves an empty feeling in the stomach. Cravings for potatoes and sweets are common; also milk, but it makes these people sick, so they have usually learned to avoid it. Nux vomica This homeopathic remedy relieves nausea and cramps from indigestion, especially after excessive eating of spicy foods or drinking of alcohol. Pulsatilla This helps relieve gastric discomfort caused by eating too much fatty food, cakes and ice cream, with bloating, belching and slow digestion. Other Remedies Antimonium crudum This relieves indigestion from eating too much, especially rich or acidic foods or cured meat. Symptoms are relieved by applying heat to the abdomen. Arsenicum album This remedy may be indicated if a person feels anxious, restless yet exhausted, and is worse from the smell and sight of food. Burning pain is felt in the stomach and esophagus, which often is relieved by warmth and sitting up. Vomiting and diarrhea are possible. Upsets from spoiled food or from eating too much fruit often respond to this remedy. Bryonia When this remedy is indicated, the stomach feels heavy, with rising acid and a bitter or sour taste. Pain and nausea are worse from motion of any kind. The person may have a dry mouth and be thirsty for long drinks, which may increase discomfort. Bryonia is strongly suggested if a person is grumpy and wants to stay completely still and not be touched or talked to. Cinchona officinalis This remedy relieves bloating of the abdomen and foul-smelling gas, sometimes with painless, but exhausting, diarrhea. Colocynthis This relieves abdominal cramps improved by bending over, with strong pressure and heat. Magnesia phosphorica This remedy relieves abdominal cramps improved by heat and bending over. Natrum phosphoricum A sour taste in the mouth, an acid or burning sensation in the stomach, sour vomiting, regurgitated bits of food, and a yellow coating on the tongue are all indications for this remedy. The person may have problems after consuming dairy products or too much sugar. Another indication for Natrum phos is a craving for fried eggs. Phosphorus Burning pain in the stomach that feels better from eating ice cream or other cold, refreshing foods suggests a need for this remedy. The person is usually thirsty for cold drinks, but often feels nauseous or vomits once liquids warm up in the stomach. People needing Phosphorus may have a tendency toward easy bleeding and sometimes develop stomach ulcers.

A26y male suffering from epigastric pain (sometimes acute) ,chest discomfort, yawning, GERD like symptoms.USG show normal.treatment going on. Pantocid dsr Od Drotin 800tds Librex bd Etiozolam 0.5 hs Recent ECG attached please DX Rx?

Patient 65year old female complaints discomfort over the neck for the past one year..mild burning while on have spicy and hot diet..no fever and no adjacent lymph nodes present..no other co morbidities Diagnosis and treatment

62 y F obese and over wt kco OA both knees comes with h/O nocturnal chet pain with suffocation and prespiration for 6 months she gave h/o taking oha for diabetes since 21/2 yrs now she also has dysphagia to solid food for couple of months x-raychest b/b pt is5month old which suggest some thing her bsl 5month old is absolutely normal todays bslR is 94mg she 75kg and height is less than 150cm thus bmi comes to 36% she is v v poor can't afford detail investigations my questions are 1 since her ecg is absolutely normal reason for nocturnal symptoms. 2 interpret x-ray chest any relation to dysphagia.