I
Duke University
Medical Center
Intercom
VOL. 25, NO. 50
DEC. 29, 1978
DURHAM, N.C.
Eat, drink, be merry, but don't overdo it
By David Williamson
The holiday season is a time to eat,
drink and be merry, but for those who eat
and drink too much, merry will be the last
feeling that comes to mind.
Instead, indigestion, heartburn,
hiccups, headaches, hangovers and worse
may be the legacy of overindulgence.
In a pre-Christmas interview. Dr.
Michael E. McLeod discussed some of
these symptoms and suggested how to
avoid them. McLeod is an associate
professor of medicine who specializes in
gastroenterology.
Imprecise terms
"Terms like 'acid indigestion' and
'heartburn' are very imprecise words that
mean different things to different
people," he said. "What some call
indigestion is really aerophagia."
Aerophagia occurs when people
swallow air while eating too fast or eating
under stress, the physician explained.
The result is a bloating pressure
discomfort in the chest or stomach.
Relief for the condition, which should
be applied discretely in most circles, is
spelled "b-e-l-c-h" or "e-r-u-c-t-a-t-i-o-
n," he said.
Heartburn, also known as acid
indigestion, occurs when hydrochloric
acid escapes from the stomach where it
belongs up into the esophagus and throat
to create a burning sensation, McLeod
said. The more precise medical term is
"gastroesophageal reflux."
Commercial antacid preparations will
neutralize the acid and generally provide
relief, he said.
Chocolate, spices, any of a variety of
other foods and smoking may bring on
heartburn in certain individuals by
relaxing the small splincter muscle that
controls the entrance to the stomach, he
said. In such cases, it is best to avoid the
Warner captures first prize
in NATO science competition
The Special Program Panel on Systems
Science of the North Atlantic Treaty
Organization (NATO) has awarded first
prize in its 1978 systems science
competition to a faculty member at the
medical center.
Dr. David Michael Warner, assistant
professor of health administration,
received an award of 100,000 Belgian
francs—approximately $4,000—for his
paper entitled "Scheduling Nursing
Personnel According to Nursing
Preference: A Mathematical Program
ming Approach."
The paper was published in the
September-October, 1976, issue of the
professional journal Operations Research
and submitted to the competition by the
journal's editor.
According to Warner, the paper
describes how a corpputer can be used to
help head nurses routinely schedule their
entire staff for four-week periods, taking
into account when each nurse would like
to work.
The object, he said, is to improve
morale among nurses through better
scheduling and to save time for the head
nurse who must devote many hours each
month to the task.
In a letter to Warner notifying him of
the award, the NATO panel called his
system "exemplary in many respects" and
said it "should lead to undertaking similar
projects in other cities and countries, as
well as in organizations other than
hospitals."
This system is already in use at the
University of Michigan and The Johns
Hopkins University. A successful pilot
study has been conducted at Duke
Hospital where the nursing service is
considering adopting it.
Warner earned his B.A. degree at Duke
in 1966, a Ph.D. in business
administration at Tulane University in
1971 and a master's in hospital
administration at Duke in 1976. He joined
the medical center faculty in 1975 after
serving three and a half years at the
University of Michigan.
Repeated attacks of heartburn pain
that return each day over several weeks
may be a sign of peptic ulcer, the
physician cautioned. Medical attention
should be sought when an ulcer is
suspected.
Antacids can cause problems
Contrary to popular opinion, he said,
there is no scientific evidence that says a
person with a peptic ulcer should eat only
bland foods. There is evidence, however,
that unsupervised chronic use of antacids
can cause kidney stones, diarrhea,
constipation or a dangerous imbalance in
the body's electrolytes, depending on the
ingredients of the drug taken.
"Walking helps the stomach go through
its normal emptying process, and so if
someone has pain from overeating, that's
what I would recommend," he said. "Both
vigorous exercise and lying down will
tend to slow emptying of the stomach."
Hiccups
Hiccups are an involuntary spasmodic
contraction of the diaphram that
produces a beginning inhalation which is
stopped suddenly as the opening in the
vocal cords snaps shut. McLeod said they
normally result from swallowing air
while eating or drinking rapidly.
"Everyone has his own pet remedy for
hiccups," gastroenterologist said.
"Taking a teaspoon of peanut butter is
one possible cure that my family swears
by."
Another potential cure for these
K
"singulti" that has many supporters is
swallowing a spoonful of sugar or salt.
Excessive alcohol
Excessive consumption of alcohol has
several potential dangers that party-
goers might not know about, McLeod
said. Severe retching can tear the
stomach where it connects with the
esophagus through powerful contrac
tions of abdominal muscles.
Since alcohol also depresses the
epiglottal reflex that prevents food from
getting into the air passages, choking on
solid food is more likely when a person is
drunk, he explained. The Heimlich
maneuver remains the best first aid when
(Continued on page 4)
SANTA'S ELVES? Two of Santa's taller helpers visited pediatric patients
last week. Jim Spanarkel (left) and Mike Gminski brought miniature
basketballs, to the delight of youngsters such as Jonathan Faircloth of
Fayetteville. The visitors, gifts and special decorations made this quite a
medical center Christmas. For more photos, see pages 2 and 3. IPholo by
Parker Herring)