Can Excessive Burping Be Caused by Anxiety?
Though cancer can cause burping, this symptom can also be caused by psychological factors.
Anxiety can cause a LOT of symptoms, including headache, backache, stomach ache, a knotty feeling in the stomach, diarrhea, a racing heart, a fluttering heart, a lump feeling in the throat …
But what about belching?
Burping is associated with obnoxious behavior and eating too much, and with gulping air with a carbonated beverage.
But can anxiety actually cause one to burp?
“Yes. Anxiety can cause excessive burping,” says Dr. Jeffrey Fine, MD, the chief of gastroenterology at the Medical Surgical Clinic of Irving.
How does this happen?
“When people become anxious, they may swallow excessive amounts of air,” says Dr. Fine.
“This is called aerophagia. When this happens, air goes into the stomach and is then forced back through the esophagus and out of the mouth – more commonly thought of as burping.”
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The solution would be to make sure that your mouth is closed during periods of anxiety. But this tactic isn’t always easy to pull off, especially if the anxiety is of an acute and severe nature.
If you’re still burping, put yourself in a state of mind that induces relaxation and calmness, and see if it goes away.
For instance, settle down in your favorite piece of furniture with some soothing music, and focus on something that will distract your mind from anxiety, such as counting backwards by seven from 100; or counting each tick of the clock in the room.
Or repeat in your head your favorite poem or song lyrics over and over.
Do this for a while and see if the burping goes away.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Aaron Amat
Can Acid Reflux Cause Bloody Stools?
Is it possible for acid reflux disease to cause blood to be in one’s stools?
“It is unlikely that acid reflux can cause blood on or in the stool,” says Dr. Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
“To have blood on or in the stool, the patient would have to have massive gastrointestinal bleeding from the esophagus and this is unlikely.
“The only way acid reflux could cause blood in a patient’s stool is if they had an esophageal ulcer eroding into a blood vessel causing rapid gastrointestinal blood loss.
“When a patient has this condition, they are more likely to be vomiting blood than to see it in their stool.”
If you’re experiencing any unnerving symptoms, insist upon a colonoscopy, even if you’re under age 50.
A colonoscopy can rule out or in a number of conditions. Do not fear a colonoscopy.
If you haven’t had any peculiar symptoms but are at least age 45, it’s time to ask your physician about a colonoscopy as a screening for colon cancer.
The age for starting screening colonoscopies was changed to 45 by the American Cancer Society in 2018 — due to the rise in colon cancer diagnosis in people under 50.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Can Exercising on an Empty Stomach Cause Acid Reflux?
Are you wondering if that discomfort in your chest or stomach while working out on an empty stomach might be from acid reflux?
“Yes, exercising on an empty stomach can cause acid reflux,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
How does this happen?
“Exercising on an empty stomach can increase intra-abdominal pressure,” explains Dr. Fine.
“Anything that increases intra-abdominal pressure can overwhelm the lower esophageal sphincter (LES) and result in reflux.”
The symptom can linger for a while after the exercise is over.
Symptoms of Acid Reflux from Exercising on an Empty Stomach
The symptoms are those that are typical of acid reflux: a discomfort in the abdominal area that can be described as an ache, mild pain or burning sensation.
This feeling can also make its way to the chest area, including what seems to be below the sternum (the esophagus is right behind the sternum).
If you’re getting chest pain every time you exercise on an empty stomach, but not when you have some food in it, then yes, this can be acid reflux.
However, make sure you have a thorough exam with a cardiologist so that a cardiac cause can be ruled out.
For example, suppose you have a normal coronary calcium score (within five years of having the test).
Suppose also that your blood pressure and cholesterol profile are in the normal range.
And let’s also say that you don’t have diabetes.
Finally, you have not noticed any unusual shortness of breath or decline in physical abilities due to increased fatigue.
Given all that — chances are extremely high that the discomfort in your chest (and especially if it’s in your abdomen) is being caused by acid reflux if it comes only when you exercise on an empty stomach.
To help prevent this annoying problem, make a point of taking in some food prior to exercising.
This could be a little yogurt, some fruit, a hardboiled egg, a handful of nuts or any small helping of a healthful food so that your stomach isn’t completely empty.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Gurgling from Stomach: Could this Be Acid Reflux?
Is that gurgling inside your stomach coming from acid reflux, cancer or what?
Now, gurgling from your stomach can be either annoying, embarrassing or scary (if you read somewhere that it could be a sign of cancer or even a brewing condition involving your heart).
Can Acid Reflux Cause a Gurgling Sound in the Belly?
“No — When your GI tract moves, it generally causes a gurgling noise,” says Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
“This is part of the natural digestive process and not due to acid reflux.”
What are the symptoms that acid reflux does cause?
The most common symptom of this very common condition is a burning or slightly abrasive feeling in the chest and/or upper abdomen.
However, the chest or abdominal discomfort from acid reflux isn’t always of a burning nature.
It can sometimes be described as a dull ache, strong ache or a pressure or heaviness.
The chest symptoms of acid reflux can mimic those of heart disease or of a heart attack.
Another common symptom of acid reflux is “burping” up a small amount of bitter tasting liquid after eating a meal — especially if you ate a lot of food in a short period of time.
The good news is that a gurgling stomach — either that which you can hear or only feel — is not cause for alarm.
The GI tract is supposed to move. The esophagus and intestines contract as part of the digestive process.
The esophagus and intestines are made of muscle, and muscle in the GI tract moves things along to get food digested. This movement is called peristalsis.
If you hear it, that’s normal. Whose stomach doesn’t gurgle sooner or later?
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Mix and Match Studio
Can HIIT Trigger Acid Reflux?
Are you wondering if high intensity interval training can bring on acid reflux?
“Yes. High intensity training can trigger acid reflux for some people, depending on what type of exercise the person is doing and how that person is wired,” explains Dr. Jeffrey Fine, MD, the chief of gastroenterology at the Medical Surgical Clinic of Irving.
“High intensity training can trigger acid reflux for some, depending on what type of exercise the person is doing and how that person refluxes,” says Dr. Fine.
Symptoms of Acid Reflux Brought on by High Intensity Interval Training
You may get a dull aching or burning in your upper abdomen.
If the acid reflux makes it higher up into your throat and mouth, you may start getting an unpleasant taste in your mouth.
This taste won’t be strong or sharp, but rather bland and dull. It may taste the way you’d imagine cardboard might taste. It may have a bitter quality to it.
It can come on within five minutes of your cardio exercise.
Dr. Fine explains, “Everyone is wired differently, neurologically speaking. Some people experience reflux only when lying down; others when sitting or standing up, and some experience it in either position.”
Can acid reflux be prevented during intense cardio training?
If you’ve been experiencing reflux symptoms as a result of HIIT, see what happens if you eat a small amount of food prior to the exercise, since an empty stomach can make you more likely to develop symptoms.
Many people perform HIIT on an empty stomach, namely to maximize the fat-burning effect.
But a small item of healthful food won’t disrupt this process.
Choose a something like a small peach, apple, banana, grapes or a little yogurt.
Another approach is to more gradually ramp your work intervals, to give your stomach a change to acclimate to the uptick in physical activity. This may result in less acid reflux.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick is a former personal trainer certified through the American Council on Exercise. At Bally Total Fitness she trained women and men of all ages for fat loss, muscle building, fitness and improved health.
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Top image: Shutterstock/Razoomanet
How Soon After Eating Chocolate Can You Get Acid Reflux?
You may know that chocolate can cause acid reflux, but how soon after eating it can it produce this symptom?
Acid reflux, even when caused by eating chocolate, can result in a burning sensation in the chest and/or the upper abdomen.
Unfortunately, chocolate is a known trigger for the reflux of acidic stomach “juices” that travel up the esophagus and cause annoying symptoms.
However, to a chocoholic, the symptoms are worth the reward.
Time It Takes Chocolate to Cause Acid Reflux After Eating It
“Eating chocolate can cause reflux,” begins Jeffrey Fine, MD, chief of gastroenterology at the Medical Surgical Clinic of Irving.
“This can occur within seconds of consuming chocolate or up to an hour afterward.”
So if you had chocolate cake, brownies or ice cream three hours ago, and seem to be having some acid reflux, chances are pretty good this is not coming from the chocolate you indulged in three hours ago—probably not even two hours ago.
How does chocolate cause reflux in the first place?
Dr. Fine explains, “Chocolate contains cocoa powder, which is an acidic substance that can directly injure the esophagus.
“In addition, it can decrease the lower esophageal sphincter (LES), which allows gastric reflux in the esophagus.”
If you’re prone to frequent episodes of acid reflux that seem strongly correlated to an intake of chocolate goods, you may want to consider discussing this with a gastroenterologist.
After all, chronic irritation to the esophagus can lead to a condition called Barrett’s esophagus — which is a risk factor for esophageal cancer.
Dr. Fine has been in practice for over 30 years and specializes in digestive health, integrative medicine and food sensitivities.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Hurst Photo
Tiny Red Speck on Tissue Paper not Always Blood
Find out what that tiny red speck on your toilet paper after wiping yourself might actually be.
Recently after wiping myself after having a “number 2,” I noticed what appeared to be a very small, faint red splotch on the tissue paper.
I couldn’t get a good close-up of it with my contact lenses on (yes, I need an updated prescription).
I was sure I wasn’t imagining the red appearance—a faded red, not a bright red.
So I popped out the contact lens, and put the tissue paper up close to my unaided eye, while covering the other eye, for a good clear inspection.
The red speck appeared to be elevated off the tissue paper. Blood doesn’t do this. That’s not blood, I thought.
With my fingernail I lifted the red speck off the tissue paper and onto my finger.
It was several fibers from some kind of garment—obviously from the red sweat pants I had worn the day before.
Conclusion: Fibers from the red sweat pants had made their way into the entrance area of my anus.
They remained there till the next day when a good wipe dislodged them and attached them to the tissue paper.
It had definitely looked like blood when it wasn’t close up and clear to my eye.
Next time you think you see a tiny speck of blood on the tissue paper after wiping yourself, get a really close, sharp look at it to see if it might instead be a few fibers of clothing material.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Can Anger Cause a Heart Attack or Stroke?
There really IS some truth to the saying, “If you don’t calm down you’ll have a heart attack.”
You’ve heard of extreme sudden fear causing a heart attack soon after, but can anger (which is a completely different emotion than is panic or fright), also lead to a heart attack or stroke?
Yes, says a study. The increased risk of heart attack or stroke, following an episode of anger, persists for up to two hours after.
The heightened risk, predictably, is much worse for people who have pre-existing risk factors for heart attack or stroke.
The study report says that high frequency of anger episodes increases the risk.
How does this all convert to numbers?
– In those with frequent outbursts of anger, five episodes per day would mean about 158 extra heart attacks per 10,000 individuals with low cardiovascular risk annually.
– The number of heart attacks jumps to 657 per 10,000 people in those who have a high cardiovascular risk.
“For people who already have issues with their heart or may have narrowed blood vessels supplying their heart, this [anger outbursts] can cause less blood flow to the heart and cause potential for heart attacks,” says Bethany Doran, MD, a board certified cardiologist and CEO of Enabled Health.
Nevertheless, a solid cause-and-effect relationship has not been established, when it comes to anger and heart attacks.
In other words, maybe people who frequently get angry are also more likely to have a high sodium junk food diet, smoke and/or not exercise.
On the other hand, mental stress drives up heart rate and blood pressure.
The so-called fight or flight response makes the blood thicken: nature’s way of protecting the body from bleeding out from the anticipated fight or escape).
The more that a person is in the midst of a stress response, the more often their blood is in a thickened state, which means it can clot more easily.
Problem is, modern man’s anger often takes place in a setting where he can’t fight or flee — such as at the workplace or stuck in a traffic jam on the way to an important appointment.
What can you do?
“Lowering risk factors for heart attacks by eating correctly, exercising and maintaining a healthy body weight can decrease risk factors for heart attack,” says Dr. Doran.
• Limit processed foods. Eat foods in their whole form as much as possible. For example, eat potatoes fresh from the produce section, not from a can.
• Keep sodium intake under 2,000 mg/day.
• Make efforts to lose excess weight via more exercise and portion control of food.
• If you smoke, quit. Limit drinking: eight ounces a day for men; four ounces a day for women.
• Do both aerobic exercise and strength training.
Bethany Doran, MD, MPH, is a board certified cardiologist and CEO of Enabled Health, a hybrid in-person and virtual clinic that expands healthcare in rural areas and prevents readmissions for vulnerable patients managing chronic disease. Her work has been supported by grants from the NIH, American Heart Association and New York Academy of Medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Freepik.com
Why You Suddenly Can’t Breathe for a Few Seconds
Do you have spells of “I can’t breathe!” that last maybe five or seven seconds?
Instead of allowing this to scare the pants off of you, see a doctor to get to the bottom of this frightening symptom.
My mother was having sporadic incidents in which she’d report, “I can’t breathe.”
Of course, she was able to breathe but said it was difficult.
She was not panting, winded or out of breath as one might be after running up a few flights of stairs.
The trouble breathing would last, as my mother said, “seconds,” and had no apparent trigger, frequently occurring when she was seated, or standing passively. Exertion did not bring it on.
If all your tests “come back normal,” it’s likely that the reason you have very brief episodes of difficulty breathing is anxiety related or a panic attack, even though right before the brief episode of breathing trouble, you weren’t thinking of anything worrisome.
Breathing Problems from a Panic Attack
“Panic attacks can cause a change in one’s ability to breathe,” says Walter Gaman, MD, FABFM, board certified in family medicine and the author of several award-winning books including “Age to Perfection: How to Thrive to 100, Happy, Healthy, and Wise.”
“Holding breath or gulping for air can be a sign of other conditions, but when all other medical tests are within normal limits, a panic attack should be considered,” continues Dr. Gaman.
“Stress and anxiety are real and panic is caused by an over-stimulation of the fight or flight response within the body.”
My mother has congestive heart failure and an ejection fraction of 25 percent, but her cardiac nurse was more interested in the idea that fluid buildup (from the CHF) was causing the episodes of I can’t breathe.
“An older patient who has a known heart failure may experience an inability to breathe,” says Dr. Gaman.
“If the chest X-ray is normal, showing no fluid or enlargement of the heart, the shortness of breath could be caused by an SVT, supraventricular tachycardia.
“This is when the heart speeds up due to a problem with the electrical signals within the heart.”
My mother’s chest X ray was normal.
There was no weight gain and no edema.
Her other cardiac tests were normal: EKG, echocardiogram (though it did show weak left ventricle—the reason for the 25 EF), blood pressure, pulse, pulse-ox, chemical stress test.
Several years ago she had coronary bypass surgery.
If episodes of SVT had been occurring only while she was at home, making her suddenly “unable to breathe” for a few seconds, these transient events would not have been picked up at the ER.
She saw a pulmonologist who ruled out COPD. The pulmonologist did not believe that the very brief episodes of difficulty breathing were caused by a lung disease or even a heart problem.
When lung disease does cause problems breathing, the episode would not just suddenly come and go and last so briefly without any exertion or pattern; it would be more of a persisting situation.
Furthermore, my mother has no other symptoms that the doctor asked about, such as dizziness, fever, lightheadedness, tingling, numbness, nausea, visual problems or rashes.
The only symptom is the periodic sensation of “I can’t breathe.”
The pulmonologist said it’s probably either anxiety related or a vocal cord dysfunction.
And remember, a panic attack can occur in the absence of precipitating worrisome thoughts.
The “program” for panic attack often runs in the background—like a computer program running in the background—not readily apparent, but there.
“Anyone [young or older] experiencing a sudden lack of breath should seek medical attention,” says Dr. Gaman.
If you’re having episodes where you have trouble breathing, and it’s not related to exertion and seems to come on for no reason at all, and are brief (lasting only seconds), get your heart and lungs checked, but it’s probably panic attacks.
Get the more serious causes of trouble breathing ruled out first.
Dr. Gaman is with Executive Medicine of Texas and is with the Staying Young Radio Show 2.0 podcast.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/ShotPrime Studio
Hydralazine (Apresoline): Is 300 Mg Daily an Overdose?
Here’s the scoop on accidentally taking 300 mg a day of hydralazine (Apresoline) instead of the prescribed 30 mg a day.
My mother’s cardiac nurse made a mistake which resulted in the pharmacist preparing her prescription for hydralazine (Apresoline) at 10 times the amount ordered by the cardiologist for high blood pressure.
About a month and a half after my mother began taking hydralazine, my father (who takes charge of all the medications) noticed a mistake:
The bottle said that each pill was 100 mg, but the dosing instructions on the bottle said to take one “10 mg” tablet three times a day.
Was this just a typographical error on the bottle, or were the tablets, that my mother had been taking at this recommendation for about a week, really 100 mg?
Well, when my father went back to the pharmacy to investigate, he compared the newly prepared, 10 mg pills to the ones in the 100 mg bottle, and they were smaller.
Initially she’d been taking just one 10 mg tablet a day. It was then increased to twice a day. Then the instructions came in for three times a day.
My father then noticed the 100 mg on the new bottle, but at first didn’t think much of it—until a week later when he just happened to notice the dosing instruction for “10 mg” three times a day.
So instead of 30 mg a day of Apresoline, my mother had been taking 300 mg a day.
My father said he was on “pins and needles” and refused to dispense to my mother any more of the pills, to clear the perceived overdose out of her system.
He called the cardiologist’s office—this was Friday. The cardiologist was out for the day.
I learned about this on Saturday and did some online research about hydralazine overdose.
I could not find how many mg of this Apresoline drug constituted an overdose, but was relieved to learn that 300 mg a day is actually a common prescription—after it gradually gets raised to this amount.
In fact, one site said 400 mg a day was sometimes prescribed, and one site even had it up to 800 mg.
Furthermore, the half life of hydralazine or Apresoline is three to seven hours, sometimes eight, meaning that half the amount of the drug is already cleared from the system in this time frame.
However, symptoms of an overdose can be the following: faintness, passing out, muscle aches, ankle swelling, chest pain, rapid heart rate.
My mother had none of these. But then again, 300 mg a day is a standard prescription amount.
However, a patient is never jumped from 30 mg a day to 300 mg a day overnight, either.
On Monday morning my parents received the phone call they were waiting for, and the cardiologist’s office told her there was no problem with the 300 mg accidental dosing, and that ironically, the doctor will probably want to go up to 300 mg a day over time anyways.
Hydralazine is a vasodilator—it opens up blood vessels so that more blood could flow through the body.
Lesson learned: Always make sure that you KNOW the dose that the doctor has prescribed, or that the doctor has changed (increased or decreased).
Make sure that this number MATCHES what’s on the prescription bottle.
Read the prescription bottle very carefully, even if you need a magnifying glass.
Have the pharmacist recite to you what the prescription is for. This is your right as the consumer!