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Burp! Belch!Help! Gastro-Esophageal Acid Reflux (GERD)

TGIF Folks! Welcome back to EUAN'S ENT Blogpost :-)


Photo illustration to show excessive acid produced in the stomach with acid

& gas reflux into the esophagus (from QUORA.COM)


Have you ever experienced that awkward burp / belch at an important social event eg at a wedding dinner and got those disapproving glances from your table guests?


Other common signs & symptoms are:

  • A burning sensation in your chest (heartburn), usually after eating a heavy meal, which might be worse at night (lying down).

  • Chest pain.

  • Difficulty swallowing.

  • Regurgitation of food or sour liquids / a sour taste in your mouth

  • Sensation of a lump in your throat.

Many of us blame chilli-🌶 hot / spicy foods for our gastric & GERD woes, and avoid taking chilli in our meals to help fix the problem.


In fact, Capsaicin is the ingredient that makes chilli peppers and chilli powder taste spicy. Researchers have noted that eating spicy foods may actually improve your GERD symptoms if you eat them on a regular basis.


Here's a useful link to learn more about foods and Acid Reflux from MEDLINE:

Foods to Avoid with Acid Reflux/GERD - Healthline


How about Fruits & Vegetables? surely these are good for me?


Fruits and vegetables are an important part of your diet. However, certain food types might make your GERD symptoms worse. The following fruits and veggies are common offenders:

  • pineapple

  • citrus fruits, such as oranges, grapefruit, lemons, and limes

  • tomatoes and tomato-based foods, such as tomato sauce, salsa and pizza sauce

  • garlic and onions

If in doubt, discuss your tolerance level with a doctor. If you have the opportunity, talking to a dietitian may also be helpful in creating a diet that helps manage your condition.


Here are some simple down to earth tips for reducing belching & acid reflux:

  • Eat and drink slowly. Taking your time can help you swallow less air. Try to make meals relaxed occasions; eating when you're stressed or on the run increases the amount of air you swallow.

  • Avoid carbonated drinks and beer. These are acidic and release carbon dioxide gas.

  • Skip the chewing gum and hard candy. When you chew gum or suck on hard candy, you swallow more often than normal. Part of what you are swallowing is a lot of air.

  • Don't smoke. When you inhale smoke, you also inhale and swallow air.

  • Check your dentures. Poorly fitting dentures can cause you to swallow excess air when you eat and drink.

  • Get moving. Exercise may help eg to take a short walk after your dinner.

  • Treat heartburn. For occasional, mild heartburn, there are many "over-the-counter" antacids or other remedies available at any pharmacy eg Guardian / APEX / Watson's.

  • In more severe cases of GERD you may require prescription-strength medication or other treatments. Do consult your GP who may refer you to see an ENT Specialist or Gastro-enterologist.

In fact, most patients in Asian countries present with persistent sore throat / lump in the throat / habitual throat clearing / dry cough, rather than obvious heart burn & belching. So many patients with GERD do present to us in ENT to rule out other causes of these symptoms.


In clinic, a check naso-endoscopy enables us to look more closely in the pharynx and larynx, to look for the tell-tale signs of GERD: from mild swelling to ulcerations or granulations at the area just behind the voice box.


Naso-endocopic view of mild to moderate GERD with

swollen edematous) arytenoids and some erythema (redness)


In most cases of GERD, we will co - manage your condition with a Gastro-enterologist to optimise your care. This may include a recommendation in change of your dietary choices and life style eg coffee and alcohol intake, and / or medication eg Proton Pump Inhibitors (PPI) such as Nexium / Losec etc and in rare cases of hiatus hernia, even surgery to correct the hernia to reduce the acid reflux upwards into the chest.


In busy & hectic Singapore, we also find that stress management helps our patients, as high stress levels tend to increase gastric acid production; so thats why we have week-ENDs (TGIF!) to give ourselves a little down time for self care.


Here is a blog with simple & useful tips on how to decrease your work stress levels:


https://cloudcone.com/stressed-out-heres-how-to-create-a-stress-free-work-environment/


So, the next time you have a big burp or belch ...... have a good think about what's causing it!


Of course, if you are worried about your symptoms, please consult your GP or friendly ENT Specialist to get it checked out.


Have a great weekend!


Dr Euan




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