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 seventh 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.
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 newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from www.rbmamall.com.
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