Dear Weijie,
Chest pains can come from a variety of causes, the delineation of
which would be beyond the scope of this post, and perhaps this list. If you
are not bothered by heartburn or vocal problems, IMO, it is unlikely you are
having significant reflux problems. Nevertheless, smaller more frequent
meals would still be a generally healthier approach than two large meals;
and can be managed with some planning, whether one lives in the city,
suburbs, or country. Furthermore, it is simply not logical to expect taking
large meals to reduce reflux.
The purpose of placing blocks (about 6 inches worth) under the legs
at the head of the bed is to raise the head of the bed so that gravity helps
to keeps the stomach contents within the stomach rather than refluxing back
up into the esophagus. One may also use large foam wedges at the head of
the bead; but not pillows as these may actually aggravate the problem by
flexing the neck and spine which may increase intra-abdominal pressure on
the stomach thereby increasing reflux. .
Foods generally will not "neutralize" acid in the stomach in any
significant way. Certain foods, such as spicey foods may stimulate gastric
acid secretion, but even so-call alkaline foods will lead to only a
temporary decrease in gastric acidity. The stomach eventually will just
make more acid. Again, the key to treatment of GERD is prevention of
reflux, not just reduction of gastric acidity. Finally, lozenges will have
no effect on gastric acidity unless they are also antacids; but even then,
the effect would only be temporary.
GWendel, MD, PhD, FACC (and more importantly...tenor)
At 04:27 AM 4/10/01 -0000, chenweijie81@y... wrote:
>Dear GWendel,
> thanks for replying back to me.Although there are many medical
>terms which I don't really understand,it seems to me that acid reflux
>is indeed a very serious matter if not treated properly.Just
>wondering. Since most of us are living in the city,it would be quite
>of hard for us to take small meals in between the day.Is it possible
>that we can take big meals at the same time reducing the chances of
>acid reflux???If not,should we learn to take small meals instead???
>Recently I have been taking large meals during lunch and
>dinner.However the good thing is that I don't take coffee,drink
>alcohol or eat chocolate.What do u mean by placing blocks under the
>legs at the head of the bed???Can u further explain???Is it also a
>measure taken too???If I am not wrong,does heartburn refers to a
>condition in which we feel unpleasant burning in the chest???If it
>is,I don't think I am having heartburn.And what kind of fruits or
>food can we take to neutralize all/some acid contents of the
>stomach???About the non-acidic contents of the stomach,I am really
>surprised that it can also damage the vocal folds.Do the non-acidic
>contents come from medicine or drugs???Any ways to prevent???How can
>I tell whether acid reflux is occuring to me besides heartburn???I
>wonder if lozenges have any effect on preventing acid reflux.Sorry if
>I am asking too many questions over here.Maybe I should ask a voice
>doctor to answer.
>
>Weijie
>Natural Baritone
>
>May the voices of nature and harmony be once combined with the hearts
>and souls of humans when the time arrives
>
>--- In vocalist-temporary@y..., >>
>> I am not a "voice doctor". However, I am an MD
>[cardiology] and do
>> see a lot of patients with "heart burn", the usual symptom of "acid
>reflux",
>> or more properly, gastroesophageal reflux disease [GERD]. It is
>caused by
>> splashing [reflux] of the acidic contents of the stomach upwards
>back into
>> the esophagus. If the reflux is severe enough, the contents can
>pass all
>> the way back up into the posterior pharynx and back down into the
>larynx
>> [particularly while the patient is asleep] to cause "reflux
>laryngitis"
>> during which the vocal folds may be severely irritated, and
>inflamed. With
>> continue irritation, ulcers may form on the vocal folds, and later,
>if left
>> untreated, scarring and nodes with permanent damage.
>>
>> Treatment is directed towards prevention of reflux and
>> neutralization of the acidic contents of the stomach. Reflux
>prevention
>> includes conservative measures such as "grazing" type eating
>habits, meaning
>> frequent small meals rather than large meals, weight loss, placing
>blocks
>> under the legs at the head of the bed, avoidance of foods/drugs
>(caffeine,
>> alcohol, chocolate) that can decrease the tone of the lower
>esophageal
>> sphincter ("LES", a kind of valve at the gastroesophageal
>junction), and
>> medications such as metoclopramide to increase the tone of the LES,
>and
>> finally surgery to support the LES by wrapping the upper part of
>the stomach
>> around it (fundo-plication). Acid neutralization (an adjunctive
>measure
>> really, because the non-acidic contents of the stomach can still
>damage the
>> delicate vocal folds) usually consists of medications like H2
>antagonists
>> (Zantac, Pepcid, Axid, Tagamet, et al) or Proton pump inhibitors
>(Prilosec,
>> Prevacid, Nexium).
>>
>> If you think you may have reflux laryngitis, you must see an
>> otorhinlaryngologist for further evaluation and testing. If you
>think it's
>> just "heartburn", please start with your family physician or
>internist; but
>> don't be satisfied with just a prescription for an acid neutralizer
>> medication. Reflux prevention is paramount, especially for singers.
>>
>> GWendel (tenor who's enjoying learning Grimoaldo in Handel's
>_Rodelinda_).
>> Fondest regards to all!
>>
>>
>> At 05:08 AM 4/9/01 -0000, chenweijie81@y... wrote:
>> >Dear teachers and friends out there,
>> > well I am a guy who have just joined vocalist-
>temporary.It's
>> >been really interesting reading all those messages out there.Indeed
>> >my knowledge of singing have increased a lot just by reading these
>> >messages here.Just a intro about myself:I am currently joining a
>> >choir in Singapore and my voice still remains as a 19 year old
>> >baritone.Just a question to ask: What exactly is acid reflux???I
>know
>> >I have been hearing a lot about it but still have no idea about
>> >it.How does it occur and are there any methods to prevent or
>reduce
>> >acid reflux???Thanks a lot.It would be helpful if voice doctors
>could
>> >explain over here.
>> >
>> >FROM NATURAL BARITONE
>> >WEIJIE
>> >
>> >
>> >
>> >
>> >
>> >
>> >
>> >
>> >Your use of Yahoo! Groups is subject to
>http://docs.yahoo.com/info/terms/
>> >
>> >
>
>
>
>
>
>Your use of Yahoo! Groups is subject to http://docs.yahoo.com/info/terms/
>
>
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