Gastroesophageal Reflux

Reflux disease refers to the flow of acid from the stomach into the esophagus and throat. Normally, a number of barriers prevent this backwards flow. Under certain conditions however the body’s defenses cannot stop the throat from being exposed to the harmful effects of stomach acid. In fact, flow can reach all the way up to the nose and sinuses.

What are the common symptoms?

Most patients are familiar with classic gastroesophageal reflux (GERD) symptoms such as burning throat, heartburn, and chest pain.

Laryngopharyngeal reflux (LPR), or reflux into the throat and voice box, produces many Extraesophageal symptoms. These are not well understood by the public and many patients don’t believe stomach acid is responsible for their problems.

Patients with laryngopharyngeal reflux may have only a few or many of the following symptoms:

  • Increased phlegm, frequent throat clearing, a chronic dry cough, postnasal drip
  • Throat fullness or foreign body sensation, difficulty swallowing
  • intermittent hoarseness, asthma or bronchitis
  • frequent or chronic sore throats, recurrent sinus infections, ear pain
Vestibular Testin

What makes reflux worse?

Diet

  • Caffeine (coffee, tea, chocolate, cola)
  • Alcohol
  • Smoking
  • Fatty or spicy foods
  • Acidic foods (spearmint, onion, tomatoes, citrus, pineapple)
  • Medicines – Some common blood pressure medicines like calcium channel blockers, beta blockers, and Valium can all worsen reflux.

Activity and Lifestyle

  • Eating before bedtime
  • Large meals
  • Weight gain, tight-fitting clothes
  • Stress and anxiety
  • Lack of exercise

What can I do to decrease GERD?

The easiest and best long term results happen with lifestyle changes.

Wear loose clothing. Avoid large meals and those foods known to precipitate reflux. Don’t eat for at least three hours before bedtime. Elevating the head of your bed with a foam wedge under the mattress or wooden blocks under the front bedposts makes it harder for the acid to travel against gravity up your throat. Cut down or eliminate smoking and drinking. Exercise regularly, watch your weight, and recognize stressors which might be contributing.

Medicines are often also necessary to control the reflux. The mainstays of therapy are antacids and proton pump inhibitors. Use these as directed by the physician. For best results we recommend that proton pump inhibitors (such as Prilosec®, Nexium®, Protonix® and AcipHex®) be taken 30 minutes before meals.

When will I see results?

Patients are frequently frustrated because they don’t notice immediate results. Be patient. The changes that happened in your throat took months to develop; they will not disappear over night. It might be weeks

or months before you notice a difference. Keep with the regimen. In fact, it may take anywhere from six weeks to six months before you notice significant change.

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