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?


Dear D.J.Y.: 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 eat slowly and in a relaxed fashion. Above all, knowing that burping does not indicate serious problems in the stomach should help your friend.

Dear Dr. Roach: I’m an amateur wind instrument player. In the past year I have decided to work on my tone quality by playing what are called “long tones.” Among other things, these strengthen one’s embouchure. For a while, I was doing these every day, but then I realized many or all muscles benefit from cross-training or a rest. Do small muscles of the mouth require cross-training or rest the same way that large weight-bearing muscles (such as those of the arms, legs and back) do?


Dear M.: All muscles need rest. The small mouth, tongue and pharynx muscles that make up the embouchure need less rest than the large arms and leg muscles, but it is important for you to rest them if they get to the point of exhaustion.

However, most of training for a musician is about fine neuromuscular control, not so much about muscle strength. For that, hours of training and practice are essential.

The concept of cross-training, by the way, is about gaining cardiovascular and total body fitness by using multiple muscles via different activities. For a musician, that might be analogous to putting down your clarinet and picking up a violin. It might improve your breadth as a musician, but only by practicing your clarinet can you get a more developed clarinet embouchure.

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