Burp­ing not usu­ally as­so­ci­ated with H. py­lori

Cape Breton Post - - ADVICE / LIFESTYLES / IN MEMORIAM - Keith Roach Dr. Roach re­grets that he is un­able to an­swer in­di­vid­ual letters, but will in­cor­po­rate them in the col­umn when­ever pos­si­ble. Read­ers may email ques­tions to ToYourGoodHealth@med.cor­nell.edu or re­quest an or­der form of avail­able health newslette

DEAR DR. ROACH: My friend was di­ag­nosed with H. py­lori. He was treated and then later he was given a stool sam­ple test. This test showed "neg­a­tive," and he was told that it means he does not have the H. py­lori bac­te­ria any­more. No more med­i­ca­tion was given to him, and no spe­cial or re­stricted diet was ad­vised.

Un­for­tu­nately, he con­tin­ues to burp all day and all night, no mat­ter what he eats or doesn't eat. He is al­ways suf­fer­ing from built-up gas. Can you ad­vise on what could be the cause? – D.J.Y.

AN­SWER: Heli­cobac­ter py­lori is a bac­te­ria species that can in­fect the lin­ing of the stom­ach. It may cause symp­toms of ab­dom­i­nal dis­com­fort, but it also causes stom­ach ul­cers in some peo­ple. It in­creases the risk of a rare can­cer of the stom­ach.

Burp­ing or belch­ing (since we doc­tors come from a tra­di­tion of speak­ing Latin, we some­times use the Latin word "eruc­ta­tion") is not typ­i­cally caused by H. py­lori; rather, it is caused by ex­ces­sive in­take of gas through eat­ing or chew­ing gum and from dis­solved gas in car­bon­ated bev­er­ages. Your friend should avoid gum and fizzy drinks; he should eat­ing slowly and in a re­laxed fash­ion. Above all, know­ing that burp­ing does not in­di­cate se­ri­ous prob­lems in the stom­ach should help your friend.

Di­ges­tive ail­ments can lead suf­fer­ers to sus­pect the worst. The book­let on colon can­cer pro­vides use­ful in­for­ma­tion on the causes and cures of this com­mon mal­ady. Read­ers can ob­tain a copy by writ­ing: Dr. Roach – No. 505, Box 536475, Or­lando, FL 32853-6475. En­close a check or money or­der (no cash) for $4.75 U.S./$6 Can. with the re­cip­i­ent's printed name and ad­dress. Please al­low four weeks for de­liv­ery.

DEAR DR. ROACH: As a re­sult of neu­rofi­bro­mato­sis type 2, I have bi­lat­eral acous­tic neu­ro­mas, which I have lived with for many years. These non­cancer­ous tu­mors, also known as schwan­no­mas, on my au­di­tory nerves have caused my hear­ing to worsen over time. What is your opin­ion about the cur­rent treat­ment op­tions for acous­tic neu­ro­mas? – T.D.

AN­SWER: Acous­tic neu­ro­mas are ex­actly as you de­scribe, non­cancer­ous tu­mors aris­ing from the Sch­wann cells that sur­round and pro­tect the eighth cra­nial nerve, which is re­spon­si­ble for hear­ing and sense of bal­ance. These tu­mors can hap­pen spo­rad­i­cally or in peo­ple with neu­rofi­bro­mato­sis type 2. The most com­mon symp­toms are grad­ual hear­ing loss and tin­ni­tus.

Treat­ment can be with surgery or ra­di­a­tion. If surgery is con­sid­ered, find an ex­pe­ri­enced sur­gi­cal team, of­ten con­sist­ing of both a neu­ro­sur­geon and a spe­cial­ist in ear surgery. Sur­gi­cal cure can be lim­ited by de­sire to pre­serve the af­fected eighth nerve and its nearby com­pan­ion, the sev­enth cra­nial nerve ( fa­cial nerve), re­spon­si­ble for mus­cle con­trol of the face. Hear­ing rarely im­proves af­ter surgery, so early iden­ti­fi­ca­tion of the cause of hear­ing loss and tin­ni­tus is crit­i­cal.

Ra­di­a­tion, in­clud­ing stereo­tac­tic tech­niques such as gamma knife, and newer modal­i­ties such as pro­ton beam, is an ef­fec­tive treat­ment also, but it may have lower rates of hear­ing preser­va­tion. The best treat­ment de­pends on so many fac­tors that only a spe­cial­ist with de­tailed in­for­ma­tion can make the cor­rect rec­om­men­da­tion.

NF2 is a rare dis­or­der (about 1 in 25,000 peo­ple) that can oc­cur in fam­i­lies or as the re­sult of a gene mu­ta­tion. Ninety to 95 per­cent of peo­ple with NF2 will de­velop acous­tic neu­ro­mas, usu­ally by age 30. Man­age­ment of acous­tic neu­ro­mas in NF2 is more com­plex than in peo­ple with spo­radic tu­mors, and usu­ally in­cludes surgery rather than ra­di­a­tion. Re­cur­rence and com­pli­ca­tion rates may be higher in NF2 pa­tients than in those with spo­radic tu­mors. Not all tu­mors need to be treated, es­pe­cially since treat­ment some­times fails. Newer treat­ments, such as be­va­cizumab, may be help­ful in NF2-as­so­ci­ated acous­tic neu­ro­mas.

More in­for­ma­tion is avail­able online at www.nfnet­work.org.

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