Swallowing Air, but Can't Burp

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Katalin

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Sep 22, 2018
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114
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Lost a loved one
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05/2018
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CA
State
Ontario
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Toronto
Hello, all, hope you can help with yet another issue: combed the threads, and don't see anything on this.

My 87-year old mother, limb onset, is having a lot of bulbar symptoms now. They've really worsened over the last few weeks.

She makes these tiny "mphhh, mphh, mphhh" noises after she eats, and says it's that she has air in her stomach, but can't burp. Those noises are the attempt to burp.

Hate to give her yet another med to swallow: I saw some recommendations for Gas-X in other situations. Maybe some plain soda water might help her to release the gas in her stomach?

Any thoughts? And with thanks in advance.

Kathy
 
What does her primary physician suggest? You should be leary of asking for suggestions on medications from a forum as people there don’t know what other medications she is taking, or her background. I occasionally have that problem and a few quick swigs of Coke Zero helps me, but it could perhaps make your mother’s situation worse. Ask her doctor.
 
Thanks, Didugan, I agree with you 100%, and I wouldn't give meds without a consultation with her doctor or pharmacist and am reluctant to start her on anything new. We don't see her physician for a home visit for another 8 days or so.

I was hoping for practical experience, like yours, so thanks for that. It seems to me also that a swig of fizzy might help. Also looking very much forward to hearing from others at this point too.

All the best,

Kathy
 
When I've had trouble I put a little baking soda in some warm water and it helps. I've also used GasX.

Have you tried to gently pat her on the back like you do to a baby after eating?
 
Thanks, Kim. Will see about the patting on the back...she's rather weak in the trunk. I think it would be hard to keep her upright while patting her back. But great suggestion for others with more trunk strength. As a family, we used to use baking soda and water for indigestion and heartburn. I think there may be contraindications? Will check with the doctor! She promised a phone call later today.

Cheers,

Kathy
 
There are contraindications and interactions for baking soda, such as kidney disease and aspirin use. Can't think of any for soda drinks, except using diet versions for diabetes.

Since acid in the stomach not being processed normally due to muscle weakness can be part of it, papaya or pineapple juice can't hurt, again with cautions for diabetics. For those who can still chew, there are chewable papaya tablets also that can help if used after meals.

Also agree that an upright position is best for any back patting/light rubbing (the latter can be upward from her upper abdomen as well).

Darrell, we can and do provide medication suggestions here, of necessity. As always, there is more information available beyond these forums about anything you might put into your body, but we do share what has worked for others, so Kathy's question is perfectly appropriate.

Best,
Laurie
 
Laurie,

I agree that Kathy’s question is completely appropriate and have no issue at all with suggestions on what has worked for others. However, unless the individual making the suggestion has the complete medical record of the patients, I would always give the caveat to check with one’s doctor on suggestions not being prescribed by the personal physician. This check is easily and quickly done with an email or electronic message in many cases.

Your advice is above is good.

Darrell

Darrell
 
Darrell,

A medical advice disclaimer is already in the terms of service for these forums, yes. And I frequently refer P/CALS to sites like drugs.com to check for potential condition/chemical interactions if/as we don't have the baseline picture.

Inescapably, however, the evidence base for symptomatic/palliative tx for most of the sx our members face is actually more robust here than what most PCPs (more likely to have the PALS' full EMR at hand, albeit with its warts) and even clinic neuros will find readily accessible. And that symptomatic treatment is fraught with competing risks that most of us believe are best parsed by patients and their caregivers.
 
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Thank-you both, Darrell and Laurie. I see the forum as definitely being an important adjunct to my mother's general practitioner. The neurologist at the clinic seems very far away, and frankly, not so useful. This doctor is young, but has a special interest in geriatrics. It is her first rodeo with ALS, and she's been open about that. She's also open to conversations about what I learn here. I'd never just rush off and do something that was recommended here without consulting, or double-checking myself. It's a good conversation to have, but it's been invaluable to me to know that treating symptoms alone is what ALS is all about, and so many of you have practical experience. The good doctor is coming on Tuesday to discuss sleep problems, (we're monkeying back and forth between zoplicone, which leaves her groggy in the morning, but works reasonably well, and trazadone, which we're trying at an increased doseage tonight because her previous dosage didn't work). She also approved Gas-X, and said to use the highest doseage (185 mg?), and not fool around with the lower doseage. She said they use it quite commonly and successfully for palliative cases. It's given at the end of a meal, no more than 3x a day, so it will be easy for her to swallow. As always, open to other suggestions. Much appreciated.
 
I don't know if she has a g-tube. If she does, just place her on her back, or at least a 45 degree recline, Then all you need to do is open the tube and let the gas out that way.
Vincent
 
If she doesn’t have a g tube, I would think carbonated liquids might make the situation worse, by creating more air in the stomach.

I favor the approach of shifting body positions and patting on the back alternating with rubbing the tummy. Gas-ex is worth a try.
 
Larry was actually helped (no tube) by diet Coke (he was a diabetic), but I would certainly favor trying warm juice first (a mild one like apple juice is another possibility, if you don't think this is really a mucus thing), ordinarily.

Let us know how the Gas-X works.

Generally better to work with trazodone for sleep (or its cousin, doxepin), than eszopiclone, which is as you say more likely to cause grogginess/confusion as it's more of a sedative. But you don't want to go up too high on trazodone for an older person esp. if she has any history of heart problems.

Given your mom's age, I would ask the doc about trying Rozerem, which is related to melatonin and has a better safety profile than other sleep aids. Or, she could try controlled-release melatonin generically -- much cheaper.

Note to the healthy--the long-term safety jury is still out on melatonin.
 
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I've experienced a great deal of gas trouble-lots of burping before I eat but mainly afterwards. The one thing that has worked well for me other than movement (getting up and changing positions) is Alka-Seltzer "Heartburn + Gas Relief Chews". My husband found the chewable form since it is easier for me than swallowing another pill or chewing a chalky item. Swallowing is not too much of a problem but I sometimes have chocked on certain textures.

Cathy
 
Vincent, Karen, Laurie, Cathy, Kim, didugan, thanks all for your suggestions. I've taken them on board, and so far, the Gas-X seems to be helping (this after a day of trials). And thanks for advice on sleeping meds. She managed 6 hours last night, and with napping, brings her up to around 8-9. I think she needs breathing support. Will talk to the clinic about that when we get in, in early January.
 
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