Dr. Keith Roach

DEAR DR. ROACH: In your recent column referring to the shingles vaccine, you do not mention younger adults. My son had a very bad case of chickenpox when he was only 6 months old. He is now 40 years old, and earlier this year had an attack of shingles that affected the area behind his ear. He wanted to get the shingles vaccine to hopefully avoid a repeat of this and was told he was too young and would have to wait until he is 50 to get it. Is he to remain susceptible to this for another 10 years? What is your opinion on this situation? — L.C.
ANSWER: The shingles vaccine has only been tested in adults over age 50, and thus is not indicated for younger ages by the Food and Drug Administration. The vaccine is particularly important in older people because shingles is more common and has a higher risk of complications in older people. People in their 40s are at low risk for complications. People who have already had shingles are still recommended for the vaccine once they are 50, but are at lower risk from shingles than those who haven’t had shingles.
Giving the vaccine to a younger person would likely be effective. This is a new vaccine, and although it seems to confer long-lasting immunity, it is not known whether it is lifelong. It would also not be covered by insurance, and is $155 for each of two doses on the Goodrx app. Personally, I wouldn’t recommend it, but it’s not out of the question. Beyond side effects of the shingles vaccine — which are often worse than a flu shot — there is little risk from the shingles shots.
DEAR DR. ROACH: I am an 88-year-old woman. I have had excessive belching for nine months. I have tried many medications and home remedies, but nothing has helped. Have you heard of this problem? I have to ride three and a half hours to see a specialist doctor. — C.M.
ANSWER: I have seen this problem often.
Eructation — we have Latin names for almost everything — or belching, is the expulsion of air from the esophagus or stomach. The average person belches 25-30 times per day. This normal body function is considered a problem only when it is excessive and causes distress.
Stomach gas is most commonly caused by swallowed air, so the treatment is to teach people how to swallow less air. This means no gum chewing or smoking; no carbonated beverages (which contain dissolved CO2 gas); and most especially slower, careful eating to reduce air swallowing during mealtimes.
Belching can also be associated with reflux disease; however, medications generally do not help the belching symptoms. Dietary treatment — that is, avoiding foods that make reflux worse (caffeine, chocolate, fatty foods, mints) — may improve the symptom.
Just reassuring people that belching is a benign condition often helps with the anxiety that can accompany the belching. Anxiety itself can make people swallow more air, so sometimes people get stuck in a vicious cycle of belching and worrying about it.
* * *
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 send mail to 628 Virginia Dr., Orlando, FL 32803.