What is GERD (chronic acid reflux)? What are the main symptoms of GERD. How common is GERD. What causes acid reflux? What are the symptoms of GERD?.

Understanding GERD (Chronic Acid Reflux)

GERD (gastroesophageal reflux disease, or chronic acid reflux) is a condition in which acid-containing contents in your stomach persistently leak back up into your esophagus, the tube from your throat to your stomach. Acid reflux happens because a valve at the end of your esophagus, the lower esophageal sphincter, doesn’t close properly when food arrives at your stomach. Acid backwash then flows back up through your esophagus into your throat and mouth, giving you a sour taste.

Acid reflux happens to nearly everyone at some point in life. Having acid reflux and heartburn now and then is totally normal. But, if you have acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn medications and antacids yet your symptoms keep returning, you may have developed GERD. Your GERD should be treated by your healthcare provider, not just to relieve your symptoms, but because GERD can lead to more serious problems.

Main Symptoms of GERD

The main symptoms of GERD are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning or trouble swallowing. You may feel like you have food stuck in your throat, or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.

What is Heartburn?

Heartburn is a symptom of acid reflux. It’s a painful burning sensation in the middle of your chest caused by irritation to the lining of the esophagus caused by stomach acid. This burning can come on anytime but is often worse after eating. For many people heartburn worsens when they recline or lie in bed, which makes it hard to get a good night’s sleep.

Fortunately, heartburn can usually be managed with over-the-counter (OTC) heartburn/acid indigestion drugs. Your healthcare provider can also prescribe stronger medicines to help tame your heartburn.

What to Do if You Have GERD

With GERD — when reflux and heartburn happen more than once in a while — the tissue lining your esophagus is getting battered regularly with stomach acid. Eventually the tissue becomes damaged. If you have this chronic acid reflux and heartburn you can see it’s affecting your daily eating and sleeping habits.

When GERD makes your daily life uncomfortable in this way, call your healthcare provider. Although GERD isn’t life-threatening in itself, its chronic inflammation of the esophagus can lead to something more serious. You may need stronger prescription medications or even surgery to ease your symptoms.

How Common is GERD?

GERD is very common. The condition and its symptoms touch a huge number of people: 20% of the U.S. population. Anyone of any age can develop GERD, but some may be more at risk for it. For example, the chances you’ll have some form of GERD (mild or severe) increase after age 40. You’re also more likely to have it if you’re overweight or obese, pregnant, smoking or are regularly exposed to second-hand smoke, or taking certain medications that may cause acid reflux.

What Causes Acid Reflux?

Acid reflux is caused by weakness or relaxation of the lower esophageal sphincter (valve). Normally this valve closes tightly after food enters your stomach. If it relaxes when it shouldn’t, your stomach contents rise back up into the esophagus. Stomach acids flow back up into the esophagus, causing reflux.

Factors that can lead to this include too much pressure on the abdomen (e.g. in pregnant women), particular types of food (e.g. dairy, spicy or fried foods) and eating habits, medications (e.g. for asthma, high blood pressure, allergies, as well as painkillers, sedatives and anti-depressants), and a hiatal hernia (where the upper part of the stomach bulges into the diaphragm).

Symptoms of GERD in Infants and Children

Infants and children can experience similar symptoms of GERD as adults, such as frequent small vomiting episodes, excessive crying and not wanting to eat (in babies and infants), other respiratory (breathing) difficulties, frequent sour taste of acid (especially when lying down), hoarse throat, feeling of choking that may wake the child up, bad breath, and difficulty sleeping after eating (especially in infants).

Differentiating Heartburn from a Heart Attack

Chest pain caused by heartburn may make you afraid you’re having a heart attack. Heartburn has nothing to do with the heart – it’s caused by stomach acid irritating the esophagus. The pain of heartburn and a heart attack can feel quite similar, but there are some key differences. Heart attack pain is usually a heavy, crushing or squeezing sensation that may radiate to the jaw, neck or arm. Heartburn pain is usually a burning sensation that is confined to the chest area. If you’re unsure, it’s always best to seek medical attention right away.

GERD (Chronic Acid Reflux): Symptoms, Treatment, & Causes

Overview

GERD or Acid Reflux

What is GERD (chronic acid reflux)?

GERD (gastroesophageal reflux disease, or chronic acid reflux) is a condition in which acid-containing contents in your stomach persistently leak back up into your esophagus, the tube from your throat to your stomach.

Acid reflux happens because a valve at the end of your esophagus, the lower esophageal sphincter, doesn’t close properly when food arrives at your stomach. Acid backwash then flows back up through your esophagus into your throat and mouth, giving you a sour taste.

Acid reflux happens to nearly everyone at some point in life. Having acid reflux and heartburn now and then is totally normal. But, if you have acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn medications and antacids yet your symptoms keep returning, you may have developed GERD. Your GERD should be treated by your healthcare provider. Not just to relieve your symptoms, but because GERD can lead to more serious problems.

What are the main symptoms of GERD (chronic acid reflux)?

The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning or trouble swallowing. You may feel like you have food stuck in your throat, or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.

What is heartburn?

Heartburn is a symptom of acid reflux. It’s a painful burning sensation in the middle of your chest caused by irritation to the lining of the esophagus caused by stomach acid.

This burning can come on anytime but is often worse after eating. For many people heartburn worsens when they recline or lie in bed, which makes it hard to get a good night’s sleep.

Fortunately, heartburn can usually be managed with over-the-counter (OTC) heartburn/acid indigestion drugs. Your healthcare provider can also prescribe stronger medicines to help tame your heartburn.

What do I do if I think I have GERD (chronic acid reflux)?

With GERD — when reflux and heartburn happen more than once in a while — the tissue lining your esophagus is getting battered regularly with stomach acid. Eventually the tissue becomes damaged. If you have this chronic acid reflux and heartburn you can see it’s affecting your daily eating and sleeping habits.

When GERD makes your daily life uncomfortable in this way, call your healthcare provider. Although GERD isn’t life-threatening in itself, its chronic inflammation of the esophagus can lead to something more serious. You may need stronger prescription medications or even surgery to ease your symptoms.

How common is GERD (chronic acid reflux)?

GERD is very common. The condition and its symptoms touch a huge number of people: 20% of the U.S. population.

Anyone of any age can develop GERD, but some may be more at risk for it. For example, the chances you’ll have some form of GERD (mild or severe) increase after age 40.

You’re also more likely to have it if you’re:

• Overweight or obese.
• Pregnant.
• Smoking or are regularly exposed to second-hand smoke.
• Taking certain medications that may cause acid reflux.

Symptoms and Causes

What causes acid reflux?

Acid reflux is caused by weakness or relaxation of the lower esophageal sphincter (valve). Normally this valve closes tightly after food enters your stomach. If it relaxes when it shouldn’t, your stomach contents rise back up into the esophagus.

Stomach acids flow back up into the esophagus, causing reflux.

Factors that can lead to this include:

• Too much pressure on the abdomen. Some pregnant women experience heartburn almost daily because of this increased pressure.
• Particular types of food (for example, dairy, spicy or fried foods) and eating habits.
• Medications that include medicines for asthma, high blood pressure and allergies; as well as painkillers, sedatives and anti-depressants.
• A hiatal hernia. The upper part of the stomach bulges into the diaphragm, getting in the way of normal intake of food.

What are the symptoms of GERD (chronic acid reflux)?

Different people are affected in different ways by GERD. The most common symptoms are:

Infants and children can experience similar symptoms of GERD, as well as:

• Frequent small vomiting episodes.
• Excessive crying, not wanting to eat (in babies and infants).
• Other respiratory (breathing) difficulties.
• Frequent sour taste of acid, especially when lying down.
• Hoarse throat.
• Feeling of choking that may wake the child up.
• Bad breath.
• Difficulty sleeping after eating, especially in infants.

How do I know I’m having heartburn and not a heart attack?

Chest pain caused by heartburn may make you afraid you’re having a heart attack. Heartburn has nothing to do with your heart, but since the discomfort is in your chest it may be hard to know the difference while it’s going on. But symptoms of a heart attack are different than heartburn.

Heartburn is that uncomfortable burning feeling or pain in your chest that can move up to your neck and throat. A heart attack can cause pain in the arms, neck and jaw, shortness of breath, sweating, nausea, dizziness, extreme fatigue and anxiety, among other symptoms.

If your heartburn medication doesn’t help and your chest pain is accompanied by these symptoms, call for medical attention right away.

Can GERD (chronic acid reflux) cause asthma?

We don’t know the exact relationship between GERD and asthma. More than 75% of people with asthma have GERD. They are twice as likely to have GERD as people without asthma. GERD may make asthma symptoms worse, and asthma drugs may make GERD worse. But treating GERD often helps to relieve asthma symptoms.

The symptoms of GERD can injure the lining of the throat, airways and lungs, making breathing difficult and causing a persistent cough, which may suggest a link. Doctors mostly look at GERD as a cause of asthma if:

• Asthma begins in adulthood.
• Asthma symptoms get worse after a meal, exercise, at night and after lying down.
• Asthma doesn’t get better with standard asthma treatments.

If you have asthma and GERD, your healthcare provider can help you find the best ways to handles both conditions — the right medications and treatments that won’t aggravate symptoms of either disease.

Is GERD (chronic acid reflux) dangerous or life-threatening?

GERD isn’t life-threatening or dangerous in itself. But long-term GERD can lead to more serious health problems:

• Esophagitis: Esophagitis is the irritation and inflammation the stomach acid causes in the lining of the esophagus. Esophagitis can cause ulcers in your esophagus, heartburn, chest pain, bleeding and trouble swallowing.
• Barrett’s esophagus: Barrett’s esophagus is a condition that develops in some people (about 10%) who have long-term GERD. The damage acid reflux can cause over years can change the cells in the lining of the esophagus. Barrett’s esophagus is a risk factor for cancer of the esophagus.
• Esophageal cancer: Cancer that begins in the esophagus is divided into two major types. Adenocarcinoma usually develops in the lower part of the esophagus. This type can develop from Barrett’s esophagus. Squamous cell carcinoma begins in the cells that line the esophagus. This cancer usually affects the upper and middle part of the esophagus.
• Strictures: Sometimes the damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus. These strictures can interfere with eating and drinking by preventing food and liquid from reaching the stomach.

Diagnosis and Tests

How is GERD (chronic acid reflux) diagnosed?

Usually your provider can tell if you have simple acid reflux (not chronic) by talking with you about your symptoms and medical history. You and your provider can talk about controlling your symptoms through diet and medications.

If these strategies don’t help, your provider may ask you to get tested for GERD. Tests for GERD include:

• Upper gastrointestinal GI endoscopy and biopsy: Your provider feeds an endoscope (a long tube with a light attached) through your mouth and throat to look at the lining of your upper GI tract (esophagus and stomach and duodenum). The provider also cuts out a small bit of tissue (biopsy) to examine for GERD or other problems.
• Upper GI series: X-rays of your upper GI tract show any problems related to GERD. You drink barium, a liquid that moves through your tract as the X-ray tech takes pictures.
• Esophageal pH and impedance monitoring and Bravo wireless esophageal pH monitoring: These tests both measure the pH levels in your esophagus. Your provider inserts a thin tube through your nose or mouth into your stomach. Then you are sent home with a monitor that measures and records your pH as you go about your normal eating and sleeping. You’ll wear the esophageal pH and impedance monitor for 24 hours while the Bravo system is worn for 48 hours.
• Esophageal manometry: A manometry tests the functionality of lower esophageal sphincter and esophageal muscles to move food normally from the esophagus to the stomach. Your provider inserts a small flexible tube with sensors into your nose. These sensors measure the strength of your sphincter, muscles and spasms as you swallow.

When does a child/infant need to be hospitalized for GERD?

GERD is usually treated on an outpatient basis. However your child will need to be hospitalized if he or she:

• Has poor weight gain or experiences a failure to thrive.
• Has cyanosis (a bluish or purplish discoloration of the skin due to deficient oxygenation of the blood) or choking spells.
• Experiences excessive irritability.
• Experiences excessive vomiting/dehydration.

Management and Treatment

What medications do I take to manage the symptoms of GERD (chronic acid reflux)?

Many over-the-counter (OTC) and prescription medications relieve GERD. Most of OTC drugs come in prescription strength too. Your provider will give you a prescription for these stronger drugs if you’re not getting relief from the OTC formulas.

The most common GERD medications:

• Antacids (provide quick relief by neutralizing stomach acids) include Tums®, Rolaids®, Mylanta®, Riopan® and Maalox®.
• H-2 receptor blockers (which decrease acid production) include Tagamet®, Pepcid AC®, Axid AR® and Zantac®.
• Proton pump inhibitors (stronger acid blockers that also help heal damaged esophagus tissue) include Prevacid®, Prilosec®, Zegerid®, Nexium®, Protonix®, AcipHex® and Dexilant®.
• Baclofen is a prescription drug used to reduce the relaxation of the lower esophageal sphincter which allows acid backwash.

Is there surgery to treat GERD (chronic acid reflux)?

GERD is usually controlled with medications and lifestyle changes (like eating habits). If these don’t work, or if you can’t take medications for an extended period, surgery may be a solution.

• Laparoscopic antireflux surgery (or Nissen fundoplication) is the standard surgical treatment. It’s a minimally invasive procedure that fixes your acid reflux by creating a new valve mechanism at the bottom of your esophagus. The surgeon wraps the upper part of the stomach (the fundus) around the lower portion of the esophagus. This reinforces the lower esophageal sphincter so food won’t reflux back into the esophagus.
• LINX device implantation is another minimally invasive surgery. A LINX device is a ring of tiny magnets that are strong enough to keep the junction between the stomach and esophagus closed to refluxing acid but weak enough to allow food to pass through.

What treatments approaches will be considered if my child has GERD?

Approaches may include one or more of the following:

• Advice on avoiding triggers (certain types of food, changing formulas in infants) that may be causing GERD symptoms or making them worse.
• Over-the-counter medications.
• Prescription medications.
• Information on proper body positioning, e.g., maintaining an upright position after eating meals/feedings.
• Surgery (reserved as a last resort, or for when certain surgical correctable causes are identified).

Prevention

How do I prevent symptoms of GERD (chronic acid reflux)?

Here are 10 tips to help prevent GERD symptoms:

1. Achieve and maintain a healthy weight.
2. Eat small, frequent meals rather than huge amounts a few times a day.
3. Reduce fat by decreasing the amount of butter, oils, salad dressings, gravy, fatty meats and full-fat dairy products such as sour cream, cheese and whole milk.
4. Sit upright while eating and stay upright (sitting or standing) for 45 to 60 minutes afterward.
5. Avoid eating before bedtime. Wait at least three hours after eating to go to bed.
6. Try not to wear clothes that are tight in the belly area. They can squeeze your stomach and push acid up into the esophagus.
7. When sleeping, raise the head of the bed 6 to 8 inches, using wooden blocks under the bedposts. Extra pillows don’t work.
8. Stop smoking.
9. Your healthcare provider may prescribe acid-reducing medications. Be sure to take them as directed.
10. Cut out possible trigger foods.

What foods should I avoid if I have GERD (chronic acid reflux)?

Adjusting your diet and eating habits play a key role in controlling the symptoms of GERD. Try to avoid the trigger foods that keep giving you heartburn.

For example, many people get heartburn from:

• Spicy foods.
• Fried foods.
• Fatty (including dairy) foods.
• Chocolate.
• Tomato sauces.
• Garlic and onions.
• Alcohol, coffee and carbonated drinks.
• Citrus fruits.

Keep a record of the trigger foods that give you trouble. Talk with your provider to get help with this. They’ll have suggestions about how to log foods and times of day you should eat.

Outlook / Prognosis

What is the outlook for GERD (chronic acid reflux)?

You can control the symptoms of GERD. If you adjust your eating and sleeping habits and take medications when needed, you should be able to get your GERD symptoms to a manageable level.

When should I call my healthcare provider?

If you experience acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn and antacids and your symptoms keep returning, call your healthcare provider.

GERD (Chronic Acid Reflux): Symptoms, Treatment, & Causes

Overview

GERD or Acid Reflux

What is GERD (chronic acid reflux)?

GERD (gastroesophageal reflux disease, or chronic acid reflux) is a condition in which acid-containing contents in your stomach persistently leak back up into your esophagus, the tube from your throat to your stomach.

Acid reflux happens because a valve at the end of your esophagus, the lower esophageal sphincter, doesn’t close properly when food arrives at your stomach. Acid backwash then flows back up through your esophagus into your throat and mouth, giving you a sour taste.

Acid reflux happens to nearly everyone at some point in life. Having acid reflux and heartburn now and then is totally normal. But, if you have acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn medications and antacids yet your symptoms keep returning, you may have developed GERD. Your GERD should be treated by your healthcare provider. Not just to relieve your symptoms, but because GERD can lead to more serious problems.

What are the main symptoms of GERD (chronic acid reflux)?

The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning or trouble swallowing. You may feel like you have food stuck in your throat, or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.

What is heartburn?

Heartburn is a symptom of acid reflux. It’s a painful burning sensation in the middle of your chest caused by irritation to the lining of the esophagus caused by stomach acid.

This burning can come on anytime but is often worse after eating. For many people heartburn worsens when they recline or lie in bed, which makes it hard to get a good night’s sleep.

Fortunately, heartburn can usually be managed with over-the-counter (OTC) heartburn/acid indigestion drugs. Your healthcare provider can also prescribe stronger medicines to help tame your heartburn.

What do I do if I think I have GERD (chronic acid reflux)?

With GERD — when reflux and heartburn happen more than once in a while — the tissue lining your esophagus is getting battered regularly with stomach acid. Eventually the tissue becomes damaged. If you have this chronic acid reflux and heartburn you can see it’s affecting your daily eating and sleeping habits.

When GERD makes your daily life uncomfortable in this way, call your healthcare provider. Although GERD isn’t life-threatening in itself, its chronic inflammation of the esophagus can lead to something more serious. You may need stronger prescription medications or even surgery to ease your symptoms.

How common is GERD (chronic acid reflux)?

GERD is very common. The condition and its symptoms touch a huge number of people: 20% of the U.S. population.

Anyone of any age can develop GERD, but some may be more at risk for it. For example, the chances you’ll have some form of GERD (mild or severe) increase after age 40.

You’re also more likely to have it if you’re:

• Overweight or obese.
• Pregnant.
• Smoking or are regularly exposed to second-hand smoke.
• Taking certain medications that may cause acid reflux.

Symptoms and Causes

What causes acid reflux?

Acid reflux is caused by weakness or relaxation of the lower esophageal sphincter (valve). Normally this valve closes tightly after food enters your stomach. If it relaxes when it shouldn’t, your stomach contents rise back up into the esophagus.

Stomach acids flow back up into the esophagus, causing reflux.

Factors that can lead to this include:

• Too much pressure on the abdomen. Some pregnant women experience heartburn almost daily because of this increased pressure.
• Particular types of food (for example, dairy, spicy or fried foods) and eating habits.
• Medications that include medicines for asthma, high blood pressure and allergies; as well as painkillers, sedatives and anti-depressants.
• A hiatal hernia. The upper part of the stomach bulges into the diaphragm, getting in the way of normal intake of food.

What are the symptoms of GERD (chronic acid reflux)?

Different people are affected in different ways by GERD. The most common symptoms are:

Infants and children can experience similar symptoms of GERD, as well as:

• Frequent small vomiting episodes.
• Excessive crying, not wanting to eat (in babies and infants).
• Other respiratory (breathing) difficulties.
• Frequent sour taste of acid, especially when lying down.
• Hoarse throat.
• Feeling of choking that may wake the child up.
• Bad breath.
• Difficulty sleeping after eating, especially in infants.

How do I know I’m having heartburn and not a heart attack?

Chest pain caused by heartburn may make you afraid you’re having a heart attack. Heartburn has nothing to do with your heart, but since the discomfort is in your chest it may be hard to know the difference while it’s going on. But symptoms of a heart attack are different than heartburn.

Heartburn is that uncomfortable burning feeling or pain in your chest that can move up to your neck and throat. A heart attack can cause pain in the arms, neck and jaw, shortness of breath, sweating, nausea, dizziness, extreme fatigue and anxiety, among other symptoms.

If your heartburn medication doesn’t help and your chest pain is accompanied by these symptoms, call for medical attention right away.

Can GERD (chronic acid reflux) cause asthma?

We don’t know the exact relationship between GERD and asthma. More than 75% of people with asthma have GERD. They are twice as likely to have GERD as people without asthma. GERD may make asthma symptoms worse, and asthma drugs may make GERD worse. But treating GERD often helps to relieve asthma symptoms.

The symptoms of GERD can injure the lining of the throat, airways and lungs, making breathing difficult and causing a persistent cough, which may suggest a link. Doctors mostly look at GERD as a cause of asthma if:

• Asthma begins in adulthood.
• Asthma symptoms get worse after a meal, exercise, at night and after lying down.
• Asthma doesn’t get better with standard asthma treatments.

If you have asthma and GERD, your healthcare provider can help you find the best ways to handles both conditions — the right medications and treatments that won’t aggravate symptoms of either disease.

Is GERD (chronic acid reflux) dangerous or life-threatening?

GERD isn’t life-threatening or dangerous in itself. But long-term GERD can lead to more serious health problems:

• Esophagitis: Esophagitis is the irritation and inflammation the stomach acid causes in the lining of the esophagus. Esophagitis can cause ulcers in your esophagus, heartburn, chest pain, bleeding and trouble swallowing.
• Barrett’s esophagus: Barrett’s esophagus is a condition that develops in some people (about 10%) who have long-term GERD. The damage acid reflux can cause over years can change the cells in the lining of the esophagus. Barrett’s esophagus is a risk factor for cancer of the esophagus.
• Esophageal cancer: Cancer that begins in the esophagus is divided into two major types. Adenocarcinoma usually develops in the lower part of the esophagus. This type can develop from Barrett’s esophagus. Squamous cell carcinoma begins in the cells that line the esophagus. This cancer usually affects the upper and middle part of the esophagus.
• Strictures: Sometimes the damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus. These strictures can interfere with eating and drinking by preventing food and liquid from reaching the stomach.

Diagnosis and Tests

How is GERD (chronic acid reflux) diagnosed?

Usually your provider can tell if you have simple acid reflux (not chronic) by talking with you about your symptoms and medical history. You and your provider can talk about controlling your symptoms through diet and medications.

If these strategies don’t help, your provider may ask you to get tested for GERD. Tests for GERD include:

• Upper gastrointestinal GI endoscopy and biopsy: Your provider feeds an endoscope (a long tube with a light attached) through your mouth and throat to look at the lining of your upper GI tract (esophagus and stomach and duodenum). The provider also cuts out a small bit of tissue (biopsy) to examine for GERD or other problems.
• Upper GI series: X-rays of your upper GI tract show any problems related to GERD. You drink barium, a liquid that moves through your tract as the X-ray tech takes pictures.
• Esophageal pH and impedance monitoring and Bravo wireless esophageal pH monitoring: These tests both measure the pH levels in your esophagus. Your provider inserts a thin tube through your nose or mouth into your stomach. Then you are sent home with a monitor that measures and records your pH as you go about your normal eating and sleeping. You’ll wear the esophageal pH and impedance monitor for 24 hours while the Bravo system is worn for 48 hours.
• Esophageal manometry: A manometry tests the functionality of lower esophageal sphincter and esophageal muscles to move food normally from the esophagus to the stomach. Your provider inserts a small flexible tube with sensors into your nose. These sensors measure the strength of your sphincter, muscles and spasms as you swallow.

When does a child/infant need to be hospitalized for GERD?

GERD is usually treated on an outpatient basis. However your child will need to be hospitalized if he or she:

• Has poor weight gain or experiences a failure to thrive.
• Has cyanosis (a bluish or purplish discoloration of the skin due to deficient oxygenation of the blood) or choking spells.
• Experiences excessive irritability.
• Experiences excessive vomiting/dehydration.

Management and Treatment

What medications do I take to manage the symptoms of GERD (chronic acid reflux)?

Many over-the-counter (OTC) and prescription medications relieve GERD. Most of OTC drugs come in prescription strength too. Your provider will give you a prescription for these stronger drugs if you’re not getting relief from the OTC formulas.

The most common GERD medications:

• Antacids (provide quick relief by neutralizing stomach acids) include Tums®, Rolaids®, Mylanta®, Riopan® and Maalox®.
• H-2 receptor blockers (which decrease acid production) include Tagamet®, Pepcid AC®, Axid AR® and Zantac®.
• Proton pump inhibitors (stronger acid blockers that also help heal damaged esophagus tissue) include Prevacid®, Prilosec®, Zegerid®, Nexium®, Protonix®, AcipHex® and Dexilant®.
• Baclofen is a prescription drug used to reduce the relaxation of the lower esophageal sphincter which allows acid backwash.

Is there surgery to treat GERD (chronic acid reflux)?

GERD is usually controlled with medications and lifestyle changes (like eating habits). If these don’t work, or if you can’t take medications for an extended period, surgery may be a solution.

• Laparoscopic antireflux surgery (or Nissen fundoplication) is the standard surgical treatment. It’s a minimally invasive procedure that fixes your acid reflux by creating a new valve mechanism at the bottom of your esophagus. The surgeon wraps the upper part of the stomach (the fundus) around the lower portion of the esophagus. This reinforces the lower esophageal sphincter so food won’t reflux back into the esophagus.
• LINX device implantation is another minimally invasive surgery. A LINX device is a ring of tiny magnets that are strong enough to keep the junction between the stomach and esophagus closed to refluxing acid but weak enough to allow food to pass through.

What treatments approaches will be considered if my child has GERD?

Approaches may include one or more of the following:

• Advice on avoiding triggers (certain types of food, changing formulas in infants) that may be causing GERD symptoms or making them worse.
• Over-the-counter medications.
• Prescription medications.
• Information on proper body positioning, e.g., maintaining an upright position after eating meals/feedings.
• Surgery (reserved as a last resort, or for when certain surgical correctable causes are identified).

Prevention

How do I prevent symptoms of GERD (chronic acid reflux)?

Here are 10 tips to help prevent GERD symptoms:

1. Achieve and maintain a healthy weight.
2. Eat small, frequent meals rather than huge amounts a few times a day.
3. Reduce fat by decreasing the amount of butter, oils, salad dressings, gravy, fatty meats and full-fat dairy products such as sour cream, cheese and whole milk.
4. Sit upright while eating and stay upright (sitting or standing) for 45 to 60 minutes afterward.
5. Avoid eating before bedtime. Wait at least three hours after eating to go to bed.
6. Try not to wear clothes that are tight in the belly area. They can squeeze your stomach and push acid up into the esophagus.
7. When sleeping, raise the head of the bed 6 to 8 inches, using wooden blocks under the bedposts. Extra pillows don’t work.
8. Stop smoking.
9. Your healthcare provider may prescribe acid-reducing medications. Be sure to take them as directed.
10. Cut out possible trigger foods.

What foods should I avoid if I have GERD (chronic acid reflux)?

Adjusting your diet and eating habits play a key role in controlling the symptoms of GERD. Try to avoid the trigger foods that keep giving you heartburn.

For example, many people get heartburn from:

• Spicy foods.
• Fried foods.
• Fatty (including dairy) foods.
• Chocolate.
• Tomato sauces.
• Garlic and onions.
• Alcohol, coffee and carbonated drinks.
• Citrus fruits.

Keep a record of the trigger foods that give you trouble. Talk with your provider to get help with this. They’ll have suggestions about how to log foods and times of day you should eat.

Outlook / Prognosis

What is the outlook for GERD (chronic acid reflux)?

You can control the symptoms of GERD. If you adjust your eating and sleeping habits and take medications when needed, you should be able to get your GERD symptoms to a manageable level.

When should I call my healthcare provider?

If you experience acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn and antacids and your symptoms keep returning, call your healthcare provider.

GERD (Chronic Acid Reflux): Symptoms, Treatment, & Causes

Overview

GERD or Acid Reflux

What is GERD (chronic acid reflux)?

GERD (gastroesophageal reflux disease, or chronic acid reflux) is a condition in which acid-containing contents in your stomach persistently leak back up into your esophagus, the tube from your throat to your stomach.

Acid reflux happens because a valve at the end of your esophagus, the lower esophageal sphincter, doesn’t close properly when food arrives at your stomach. Acid backwash then flows back up through your esophagus into your throat and mouth, giving you a sour taste.

Acid reflux happens to nearly everyone at some point in life. Having acid reflux and heartburn now and then is totally normal. But, if you have acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn medications and antacids yet your symptoms keep returning, you may have developed GERD. Your GERD should be treated by your healthcare provider. Not just to relieve your symptoms, but because GERD can lead to more serious problems.

What are the main symptoms of GERD (chronic acid reflux)?

The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning or trouble swallowing. You may feel like you have food stuck in your throat, or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.

What is heartburn?

Heartburn is a symptom of acid reflux. It’s a painful burning sensation in the middle of your chest caused by irritation to the lining of the esophagus caused by stomach acid.

This burning can come on anytime but is often worse after eating. For many people heartburn worsens when they recline or lie in bed, which makes it hard to get a good night’s sleep.

Fortunately, heartburn can usually be managed with over-the-counter (OTC) heartburn/acid indigestion drugs. Your healthcare provider can also prescribe stronger medicines to help tame your heartburn.

What do I do if I think I have GERD (chronic acid reflux)?

With GERD — when reflux and heartburn happen more than once in a while — the tissue lining your esophagus is getting battered regularly with stomach acid. Eventually the tissue becomes damaged. If you have this chronic acid reflux and heartburn you can see it’s affecting your daily eating and sleeping habits.

When GERD makes your daily life uncomfortable in this way, call your healthcare provider. Although GERD isn’t life-threatening in itself, its chronic inflammation of the esophagus can lead to something more serious. You may need stronger prescription medications or even surgery to ease your symptoms.

How common is GERD (chronic acid reflux)?

GERD is very common. The condition and its symptoms touch a huge number of people: 20% of the U.S. population.

Anyone of any age can develop GERD, but some may be more at risk for it. For example, the chances you’ll have some form of GERD (mild or severe) increase after age 40.

You’re also more likely to have it if you’re:

• Overweight or obese.
• Pregnant.
• Smoking or are regularly exposed to second-hand smoke.
• Taking certain medications that may cause acid reflux.

Symptoms and Causes

What causes acid reflux?

Acid reflux is caused by weakness or relaxation of the lower esophageal sphincter (valve). Normally this valve closes tightly after food enters your stomach. If it relaxes when it shouldn’t, your stomach contents rise back up into the esophagus.

Stomach acids flow back up into the esophagus, causing reflux.

Factors that can lead to this include:

• Too much pressure on the abdomen. Some pregnant women experience heartburn almost daily because of this increased pressure.
• Particular types of food (for example, dairy, spicy or fried foods) and eating habits.
• Medications that include medicines for asthma, high blood pressure and allergies; as well as painkillers, sedatives and anti-depressants.
• A hiatal hernia. The upper part of the stomach bulges into the diaphragm, getting in the way of normal intake of food.

What are the symptoms of GERD (chronic acid reflux)?

Different people are affected in different ways by GERD. The most common symptoms are:

Infants and children can experience similar symptoms of GERD, as well as:

• Frequent small vomiting episodes.
• Excessive crying, not wanting to eat (in babies and infants).
• Other respiratory (breathing) difficulties.
• Frequent sour taste of acid, especially when lying down.
• Hoarse throat.
• Feeling of choking that may wake the child up.
• Bad breath.
• Difficulty sleeping after eating, especially in infants.

How do I know I’m having heartburn and not a heart attack?

Chest pain caused by heartburn may make you afraid you’re having a heart attack. Heartburn has nothing to do with your heart, but since the discomfort is in your chest it may be hard to know the difference while it’s going on. But symptoms of a heart attack are different than heartburn.

Heartburn is that uncomfortable burning feeling or pain in your chest that can move up to your neck and throat. A heart attack can cause pain in the arms, neck and jaw, shortness of breath, sweating, nausea, dizziness, extreme fatigue and anxiety, among other symptoms.

If your heartburn medication doesn’t help and your chest pain is accompanied by these symptoms, call for medical attention right away.

Can GERD (chronic acid reflux) cause asthma?

We don’t know the exact relationship between GERD and asthma. More than 75% of people with asthma have GERD. They are twice as likely to have GERD as people without asthma. GERD may make asthma symptoms worse, and asthma drugs may make GERD worse. But treating GERD often helps to relieve asthma symptoms.

The symptoms of GERD can injure the lining of the throat, airways and lungs, making breathing difficult and causing a persistent cough, which may suggest a link. Doctors mostly look at GERD as a cause of asthma if:

• Asthma begins in adulthood.
• Asthma symptoms get worse after a meal, exercise, at night and after lying down.
• Asthma doesn’t get better with standard asthma treatments.

If you have asthma and GERD, your healthcare provider can help you find the best ways to handles both conditions — the right medications and treatments that won’t aggravate symptoms of either disease.

Is GERD (chronic acid reflux) dangerous or life-threatening?

GERD isn’t life-threatening or dangerous in itself. But long-term GERD can lead to more serious health problems:

• Esophagitis: Esophagitis is the irritation and inflammation the stomach acid causes in the lining of the esophagus. Esophagitis can cause ulcers in your esophagus, heartburn, chest pain, bleeding and trouble swallowing.
• Barrett’s esophagus: Barrett’s esophagus is a condition that develops in some people (about 10%) who have long-term GERD. The damage acid reflux can cause over years can change the cells in the lining of the esophagus. Barrett’s esophagus is a risk factor for cancer of the esophagus.
• Esophageal cancer: Cancer that begins in the esophagus is divided into two major types. Adenocarcinoma usually develops in the lower part of the esophagus. This type can develop from Barrett’s esophagus. Squamous cell carcinoma begins in the cells that line the esophagus. This cancer usually affects the upper and middle part of the esophagus.
• Strictures: Sometimes the damaged lining of the esophagus becomes scarred, causing narrowing of the esophagus. These strictures can interfere with eating and drinking by preventing food and liquid from reaching the stomach.

Diagnosis and Tests

How is GERD (chronic acid reflux) diagnosed?

Usually your provider can tell if you have simple acid reflux (not chronic) by talking with you about your symptoms and medical history. You and your provider can talk about controlling your symptoms through diet and medications.

If these strategies don’t help, your provider may ask you to get tested for GERD. Tests for GERD include:

• Upper gastrointestinal GI endoscopy and biopsy: Your provider feeds an endoscope (a long tube with a light attached) through your mouth and throat to look at the lining of your upper GI tract (esophagus and stomach and duodenum). The provider also cuts out a small bit of tissue (biopsy) to examine for GERD or other problems.
• Upper GI series: X-rays of your upper GI tract show any problems related to GERD. You drink barium, a liquid that moves through your tract as the X-ray tech takes pictures.
• Esophageal pH and impedance monitoring and Bravo wireless esophageal pH monitoring: These tests both measure the pH levels in your esophagus. Your provider inserts a thin tube through your nose or mouth into your stomach. Then you are sent home with a monitor that measures and records your pH as you go about your normal eating and sleeping. You’ll wear the esophageal pH and impedance monitor for 24 hours while the Bravo system is worn for 48 hours.
• Esophageal manometry: A manometry tests the functionality of lower esophageal sphincter and esophageal muscles to move food normally from the esophagus to the stomach. Your provider inserts a small flexible tube with sensors into your nose. These sensors measure the strength of your sphincter, muscles and spasms as you swallow.

When does a child/infant need to be hospitalized for GERD?

GERD is usually treated on an outpatient basis. However your child will need to be hospitalized if he or she:

• Has poor weight gain or experiences a failure to thrive.
• Has cyanosis (a bluish or purplish discoloration of the skin due to deficient oxygenation of the blood) or choking spells.
• Experiences excessive irritability.
• Experiences excessive vomiting/dehydration.

Management and Treatment

What medications do I take to manage the symptoms of GERD (chronic acid reflux)?

Many over-the-counter (OTC) and prescription medications relieve GERD. Most of OTC drugs come in prescription strength too. Your provider will give you a prescription for these stronger drugs if you’re not getting relief from the OTC formulas.

The most common GERD medications:

• Antacids (provide quick relief by neutralizing stomach acids) include Tums®, Rolaids®, Mylanta®, Riopan® and Maalox®.
• H-2 receptor blockers (which decrease acid production) include Tagamet®, Pepcid AC®, Axid AR® and Zantac®.
• Proton pump inhibitors (stronger acid blockers that also help heal damaged esophagus tissue) include Prevacid®, Prilosec®, Zegerid®, Nexium®, Protonix®, AcipHex® and Dexilant®.
• Baclofen is a prescription drug used to reduce the relaxation of the lower esophageal sphincter which allows acid backwash.

Is there surgery to treat GERD (chronic acid reflux)?

GERD is usually controlled with medications and lifestyle changes (like eating habits). If these don’t work, or if you can’t take medications for an extended period, surgery may be a solution.

• Laparoscopic antireflux surgery (or Nissen fundoplication) is the standard surgical treatment. It’s a minimally invasive procedure that fixes your acid reflux by creating a new valve mechanism at the bottom of your esophagus. The surgeon wraps the upper part of the stomach (the fundus) around the lower portion of the esophagus. This reinforces the lower esophageal sphincter so food won’t reflux back into the esophagus.
• LINX device implantation is another minimally invasive surgery. A LINX device is a ring of tiny magnets that are strong enough to keep the junction between the stomach and esophagus closed to refluxing acid but weak enough to allow food to pass through.

What treatments approaches will be considered if my child has GERD?

Approaches may include one or more of the following:

• Advice on avoiding triggers (certain types of food, changing formulas in infants) that may be causing GERD symptoms or making them worse.
• Over-the-counter medications.
• Prescription medications.
• Information on proper body positioning, e.g., maintaining an upright position after eating meals/feedings.
• Surgery (reserved as a last resort, or for when certain surgical correctable causes are identified).

Prevention

How do I prevent symptoms of GERD (chronic acid reflux)?

Here are 10 tips to help prevent GERD symptoms:

1. Achieve and maintain a healthy weight.
2. Eat small, frequent meals rather than huge amounts a few times a day.
3. Reduce fat by decreasing the amount of butter, oils, salad dressings, gravy, fatty meats and full-fat dairy products such as sour cream, cheese and whole milk.
4. Sit upright while eating and stay upright (sitting or standing) for 45 to 60 minutes afterward.
5. Avoid eating before bedtime. Wait at least three hours after eating to go to bed.
6. Try not to wear clothes that are tight in the belly area. They can squeeze your stomach and push acid up into the esophagus.
7. When sleeping, raise the head of the bed 6 to 8 inches, using wooden blocks under the bedposts. Extra pillows don’t work.
8. Stop smoking.
9. Your healthcare provider may prescribe acid-reducing medications. Be sure to take them as directed.
10. Cut out possible trigger foods.

What foods should I avoid if I have GERD (chronic acid reflux)?

Adjusting your diet and eating habits play a key role in controlling the symptoms of GERD. Try to avoid the trigger foods that keep giving you heartburn.

For example, many people get heartburn from:

• Spicy foods.
• Fried foods.
• Fatty (including dairy) foods.
• Chocolate.
• Tomato sauces.
• Garlic and onions.
• Alcohol, coffee and carbonated drinks.
• Citrus fruits.

Keep a record of the trigger foods that give you trouble. Talk with your provider to get help with this. They’ll have suggestions about how to log foods and times of day you should eat.

Outlook / Prognosis

What is the outlook for GERD (chronic acid reflux)?

You can control the symptoms of GERD. If you adjust your eating and sleeping habits and take medications when needed, you should be able to get your GERD symptoms to a manageable level.

When should I call my healthcare provider?

If you experience acid reflux/heartburn more than twice a week over a period of several weeks, constantly take heartburn and antacids and your symptoms keep returning, call your healthcare provider.

That Sore Throat Could be Caused by Acid Reflux: 1st Choice Urgent Care: Urgent Care

More than 60% of Americans experience acid reflux every month. If you’ve ever felt a burning sensation or felt as if there were a lump in your throat, chances are high that you’ve had acid reflux.

It’s a common condition in which the acid in your stomach escapes and travels into your food tube, or esophagus. The highly acidic fluid irritates the lining of your esophagus and brings with it common symptoms like burning in the throat, hoarseness, and more. A common, but lesser-known, symptom of acid reflux is a sore throat. If you have a sore throat, you might think you’re getting sick. But, the irritation that acid reflux causes can give you a sore throat.

Though acid reflux itself isn’t life-threatening, it can lead to esophagus damage and discomfort. To learn more about the symptoms of acid reflux and get help finding a treatment plan for you, talk to Yadwinder Kang, MD at First Choice Urgent Care.

Why acid reflux makes your throat sore

Acid reflux occurs when stomach acid travels backward out of your stomach and up into your esophagus. Your esophagus is the tube through which food travels, connecting your mouth to your stomach. The lower esophageal sphincter is a small band of muscle at the bottom of your esophagus that typically keeps stomach acid from flowing up. However, the lower esophageal sphincter can weaken, and stomach acid can leak into your esophagus.

Stomach acid is a fluid that helps your body digest food, but when it gets into your esophagus, it can cause discomfort and irritation. Symptoms of heartburn, like a burning sensation in your throat, are due to stomach acid traveling back up your esophagus.

Acid reflux can irritate and damage the lining of your esophagus, and this can cause a sore throat. Other common symptoms of heartburn include:

• A burning sensation in the throat
• The feeling of a lump in the throat
• Chronic cough
• Hoarseness
• Bad breath
• Chest discomfort

Although sore throats that come with the flu or other viruses often go away once your body heals, a sore throat from acid reflux is best managed by treating the cause of the discomfort. GERD is a term for gastroesophageal reflux disease, or chronic heartburn.

Managing heartburn

Many patients find relief from GERD and acid reflux by making lifestyle changes. Certain foods and drinks can increase your risk of heartburn, including carbonated or caffeinated drinks. Keep in mind that everyone’s triggers are different. Consider keeping a food journal to learn which foods and beverages might cause your acid reflux symptoms to increase.

Common heartburn remedies include:

• Avoiding spicy food
• Avoiding fatty foods
• Avoiding carbonated, caffeinated, or alcoholic beverages
• Avoiding citrus and tomato juices, which are acidic
• Not smoking

Eating smaller, more frequent meals can help aid in digestion. Maintaining a healthy weight and not wearing tight clothes might also help prevent acid reflux. Over-the-counter medications like antacids help neutralize stomach acid with salts and hydroxide or bicarbonate ions. Other medications keep your stomach from producing excessive stomach acid.

For more serious cases of acid reflux, Dr. Kang can give you a prescription medication. These medications can help eliminate or neutralize stomach acid to decrease esophagus irritation. Combined with lifestyle changes, medication can treat a sore throat due to acid reflux.

When you come to First Choice Urgent Care for treatment, our caring team is here to help. Together, you and Dr. Kang review your medical history and symptoms to determine the best course of treatment for your acid reflux. If you think you might have GERD or acid reflux, call our Bakersfield, California office, or schedule your first appointment online today.

Could Your Sore Throat Be Caused by Acid Reflux?

Have you had a cough, tickle in the throat, itchy throat, or raspy voice that will not go away despite not having a cold or feeling sick? Is excess mucus causing you to clear your throat so often that it is annoying and, at times, embarrassing?  Many who suffer from these symptoms are treated by doctors and urgent care physicians with allergy medications, nasal sprays, decongestants, and even antibiotics. Despite this, symptoms do not get better. Often these symptoms are not caused by allergies, a sinus infection, or a cold, but by laryngopharyngeal reflux (LPR). Also called airway reflux, reflux laryngitis, or atypical reflux, LPR is one of the most common diseases of the 21st century. Unlike gastroesophageal reflux disease (GERD), which primarily affects the esophagus, LPR will affect the larynx and pharynx—your voice production system.  Lissette Giraud, MD, provides insight into and answers common questions about this widespread condition.  

What causes LPR?

It is commonly accepted that this condition is caused by reflux of acid or bile. GERD symptoms like heartburn are not typical of the condition but may appear. The most common symptoms of LPR are hoarseness, sore throat, excess mucus in the throat, persistent cough, asthma-like, symptoms (wheezing, chest tightness, and difficulty breathing), postnasal drip, sensation of a lump in the throat, difficulties swallowing, and ear pain. However, LPR presents differently in each person.

When should I see a doctor?

If you have a sore throat, painful swallowing, cough, difficulty swallowing, or hoarseness for 10-14 days, you should seek medical attention, preferably from an ENT.

What is the treatment for LPR?

Treatment will vary in accordance with the severity of symptoms. It can be as simple as making changes to your diet, like avoiding spicy foods, tomatoes, chocolate, caffeine, citrus beverages or foods, and alcohol.

Other solutions include:

• Avoiding large meals
• Eating three hours or more prior to going to bed
• Elevating the head eight inches when sleeping
• Smoking cessation
• Losing weight if you are overweight

Your doctor may also recommend a medication to reduce acid production in the stomach, like Zantac or Pepcid, for a few weeks or longer.Stronger medications may be recommended if diet and life style changes have not worked.

Do I need any tests like CT scans, X-rays, or MRI’s to diagnose LPR?

The diagnosis of LPR is mostly based on symptoms and an office procedure called flexible laryngoscopy—an endoscopic exam of the voice box and throat performed by an ENT—and response to treatment. In some cases an upper endoscopy examination to evaluate the stomach and esophagus for inflammation, ulcers, or any abnormal lesion may be recommended. More advanced tests like pH testing and esophageal manometry are less frequently recommended and are typically done for difficult cases.

What are the complications from untreated LPR?

If LPR is left untreated, patients may experience vocal cord lesions like polyps or granulomas, chronic laryngitis, or asthma.

If you or a loved one suffers from the above symptoms, visit an ENT doctor, who will be prepared to do a complete evaluation and determine if you have LPR and recommend treatment.

Could Your Sore Throat Be Caused by ‘Silent Reflux’?

Despite its name, silent reflux, also known as Laryngopharyngeal Reflux (LPR), is anything but quiet. The condition, which causes throat irritation and pain, is referred to as silent reflux because it often lacks the hallmark symptom of GERD and typical acid reflux – heartburn.

Despite the absence of heartburn, many people with LPR report a wide variety of symptoms due to the damage the acid causes to their voice box, respiratory system, teeth, and throat.

“Reflux can be what we call extra-esophageal,” notes Michael Vaezi, MD, PhD, clinical director of the division of gastroenterology and hepatology and director of the Center for Esophageal Motility Disorders at Vanderbilt University in Nashville, Tenn. “These patients may not have heartburn sensation in the chest. It’s not really silent, [but it is] presenting atypically.”

Not So Silent Symptoms

If you have LPR you may experience:

• Hoarseness. As stomach acid comes up onto your voice box, or larynx, you may find your voice sounds more hoarse or harsh than usual. This symptom may be particularly noticeable in the mornings, since acid is often more likely to move up the throat when you are lying down.
• Throat problems. Acid reflux into the pharynx, or back of the throat, can also cause atypical symptoms. You may feel as if you constantly have sore throat, or always need to clear your throat. Additionally, it may feel as if there is a lump in the back of your throat that won’t go away. Other symptoms include frequent hiccups, trouble swallowing, or a nagging cough.
• Respiratory problems. People with silent reflux can experience wheezing or difficulty catching their breath as a result of airway irritation due to acid reflux. LPR can often exacerbate underlying asthma and make it more difficult to treat.
• Tooth decay. Stomach acid that backs up into the mouth can erode or eat away at the protective enamel of the teeth, causing teeth to become fragile and discolored.

RELATED: 7 Surprising Facts About GERD and Acid Reflux

Treating Silent Reflux

If your doctor suspects LPR they may order some tests to confirm their diagnosis and determine which treatment option is best for you. These tests include:

• Barium swallow. This test involves a series of X-rays of the upper gastrointestinal system, or digestive tract, performed after a patient drinks a special barium solution. The contrast solution allows doctors to evaluate the digestive tract for structural problems that may be associated with LPR.
• Endoscopy. Doctors insert a lighted tube attached to a small camera into the throat. The tube is used to examine the larynx, pharynx, and esophagus for signs of damage consistent with acid reflux. Tissue samples are usually taken to test in the laboratory for any evidence of chronic irritation, inflammation, infection, or abnormal cells.
• pH monitoring. A thin tube is inserted through the patient’s nose and down into the esophagus. A device at the end of the tube measures the acidity, or pH, of the inside of the esophagus over a period of one to two days. Alternatively, a capsule is attached to the wall of the esophagus to monitor pH levels. The capsule then detaches and is passed through the patient’s digestive system. Abnormally high levels of acidity are suggestive of LPR.
• Proton pump inhibitor test. Your doctor may try to diagnose your problem by treating you with a trial of proton pump inhibitors, which reduce the amount of acid secreted by the stomach. If your symptoms improve or disappear with medication then you most likely have LPR.

Silent reflux is most often treated with proton pump inhibitors such as Nexium (esomeprazole), Protonix (pantoprazole), Prevacid (lansoprazole), Aciphex (rabeprazole), or Prilosec (omeprazole).

Lifestyle changes can also help reduce LPR symptoms. Your doctor may recommend:

• Quitting smoking
• Avoiding alcohol
• Eliminating caffeine
• Losing weight
• Ditching meals three hours prior to bedtime
• Elevating the head of your bed four to six inches
• Avoiding restrictive clothing
• Dietary changes (Foods that are fatty, fried, spicy, or include mint or chocolate should be avoided)

In some cases, LPR symptoms may persist despite lifestyle changes and medications. In these instances, surgery may be recommended to tighten the lower esophageal sphincter.

Although LPR is an uncomfortable and potentially serious condition, with the right diagnosis it is possible to keep symptoms under control and avoid complications.

Laryngeal Pharyngeal Reflux – About GERD

Laryngeal pharyngeal reflux (LPR) At A Glance

• Reflux of gastric acid can cause several throat problems
• Symptoms and treatment of LPR are often different from typical GERD symptoms
• LPR will usually heal well with proper diagnosis and treatment

Many people with throat discomfort are surprised when they are told by their doctor that they have laryngeal pharyngeal reflux (LPR). Gastric acid can cause significant inflammation when it falls on the vocal cords.

If this happens repeatedly, a person can be left with a number of bothersome throat problems. Examples include:

• Hoarseness
• Frequent throat clearing
• Coughing,
• Sensation like something stuck in the throat

There are individuals with gastroesophageal reflux disease (GERD) who have throat discomfort. People with GERD have gastric reflux into the esophagus. This typically causes heartburn and regurgitation (a sense of fluid coming up).

Many people with LPR do not have any of the typical GERD symptoms.

Learn more about the symptoms of GERD

This has lead to some controversies and misunderstandings about LPR:

• Is it a symptom of GERD?
• Are patients with it a subset of GERD?
• Is it a completely different medical problem?

There is not a good answer to these questions, as there is some truth to each of them. It may be easier for physicians to manage LPR if it’s approached as a completely different problem.

People with GERD nearly always have heartburn. Additionally, they:

• Usually improve quickly with appropriate medical treatment
• Frequently require life-long medical treatment
• Are at risk for developing significant damage to the lining of the esophagus, including esophagitis or sometimes Barrett’s esophagus

On the other hand, LPR is quite different. Many people with LPR do not have heartburn. Additionally, they:

• Require larger doses of medications for weeks to months before seeing any improvement
• Usually do not require long-term treatment
• Rarely develop complications

Causes

LPR frequently begins after an upper respiratory illness. However, some of the symptoms seem to linger after the cold or flu is better. The theory is that there is some reflux of stomach acid into the throat, which irritates the already irritated vocal cords. If the acid reflux continues, the damage to the vocal cords will progress.

The amount of acid reflux required to cause this is very small. This explains why most of these individuals do not have heartburn. The injury may be greater in people who use their voice vigorously, such as singers or teachers.

Symptoms

Individuals with persistent throat symptoms, such as hoarseness, frequent throat clearing, or coughing should seek medical attention. The feeling that there is something stuck in the throat, a globus sensation, is a classic symptom of LPR.

Read more about Globus

Throat pain, weight loss, or smoking history should be considered worrisome. Throat pain is an uncommon manifestation of LPR.

Most patients eventually have a test called laryngoscopy by an ear, nose and throat (ENT) doctor. With this test, the ENT physician can visualize the vocal cords and look for the characteristic findings of LPR, such as swelling. Unfortunately, many people with normal examinations or a little redness are told incorrectly that they have LPR.

Treatment

Once the diagnosis is suspected, two things will help:

1. The reflux needs to be well controlled. This usually requires a twice a day dose of a proton pump inhibitor (PPI). These powerful medications suppress stomach acid and relieve acid reflux. It often requires treatment for 2–6 months before significant improvement is seen.
2. Attempts to improve vocal hygiene should be undertaken. The person should drink plenty of liquids to prevent a dry throat. Caffeine, alcohol, antihistamines, and menthol containing cough drops all have a drying effect and should be avoided. Avoid tobacco. Care needs to be taken to not overuse the voice by shouting, whispering, speaking for a long period of time, or clearing the throat.

Throat clearing is a common symptom. However, it tends to worsen the injury. Here are 3 things that may help stop the throat clearing:

1. Try swallowing to clear the throat
2. Exhale forcefully rather than cough
3. Gently tap the vocal cords together rather than a forceful effort to clear the throat

People who improve should talk to their doctor to try to stop their anti-reflux medications. The majority of individuals with LPR do not require life-long medical treatment for their reflux.

Those who do not improve should see their doctor and consider a repeat laryngoscopic examination to re-evaluate the diagnosis.

The doctor may also consider doing a test to precisely measure acid reflux, such as ambulatory pH monitoring. In this test, a thin tube is passed through the nose and into the esophagus. The pH can be measured every few seconds for 24 hours. Rarely, people with LPR have severe enough symptoms that they require anti-reflux surgery.

Individuals with LPR usually do well with proper diagnosis and treatment. It may take several months for this to happen.

The keys to success are:

• An accurate diagnosis
• Good control of acid reflux
• Good vocal hygiene during the healing process

Adapted from IFFGD Publication: Another Complication of Reflux: Laryngeal Pharyngeal Reflux (LPR) by J. Patrick Waring, MD, Digestive Healthcare of Georgia, Atlanta, GA.

Differential diagnosis of sore throat

I.B. ANGOTOEVA , Ph.D., Department of Otorhinolaryngology, Russian Medical Academy of Postgraduate Education

Sore throat is a complaint with which patients often turn to ENT doctor and therapist. However, a sore throat does not always mean a sore throat or other inflammatory disease of the oropharynx. This statement is of practical importance, since, as the author hopes, it will help the doctor to make a differential diagnosis of diseases in which a sore throat may occur.Ultimately, if it was possible to correctly diagnose, an opportunity is provided to provide qualified assistance.

Most often, sore throat worries patients with acute respiratory viral infection (ARVI). Sore throat with ARVI is usually mild, mostly patients complain of a sore throat or mild pain when swallowing. Sore throat with ARVI is accompanied by cough and runny nose. Moreover, an important point is the fact that the onset of the disease manifests itself in the nasal cavity, only then pains in the throat join.

Etiological diagnosis is difficult, especially in routine practice. The doctor at the initial appointment cannot say for sure which virus caused this infection in a particular patient. Having only time to collect complaints and anamnesis, with the classic clinical picture, the doctor can assume the influence of a particular virus with which he is dealing. In this position, practitioners are forced to rely on literature data. In most cases (20-30%), it is not possible to accurately identify the virus that caused the disease in a given person, even with the help of a virological laboratory.The data of successful diagnosis verification in the 1st place in the etiology of acute respiratory viral infections of the upper respiratory tract put rhinoviruses (30-50%). It should be noted that the influenza virus causes only 5 to 15% of all ARVI cases [3]. At the same time, the etiological treatment of ARVI exists mainly against influenza viruses. This explains the failure of the empirical choice of antiviral drugs. Therefore, it is necessary to carry out symptomatic treatment, which is based on topical preparations. Antiseptics are the drugs of choice for sore throat with ARVI.For severe sore throat, drugs containing non-steroidal anti-inflammatory drugs are used. In some cases, it is possible to use the drug Erespal, which has a complex effect on the body: antihistamine, anti-inflammatory, antispasmodic.

Angina is an infectious disease with a predominant lesion of the tonsils, which is most often caused by a streptococcal infection (Streptococcus pyogenes). However, the cause of sore throat can be fungi, viruses and other bacterial agents:

• Staphylococcus aureus,
• Diplococcus pneumoniae,
• Cory-nebacterium diphtheriae,
• Bordetella pertussis,
• Haemophilus influenzae,
• Neisseria species.

Route of infection: airborne (when a patient sneezes and coughs, as well as through dishes and other household items). The incubation period is 1-2 days.

Types of tonsillitis :

1. Catarrhal tonsillitis ( Fig. 1 ) – characterized by hyperemia of the mucous membrane of the palatine tonsils

…

Catarrhal sore throat should be distinguished from a respiratory viral infection, in which hyperemia and edema of the mucous membrane are mainly observed on the posterior wall of the pharynx, and not on the palatine tonsils ( Fig.2 ).

In addition, with angina, the patient will not complain of cough and runny nose, and with ARVI, most often the disease begins with a runny nose, and sore throat and sore throat join later. If the patient remains untreated, then catarrhal tonsillitis can turn into follicular and even lacunar tonsillitis.

2. Follicular tonsillitis is characterized by more pronounced pain in the throat and purulent inflammation in the lacunae, which looks like clearly delineated islets ( fig.3 ). Sore throat is intense on swallowing.

3. With lacunar angina, the palatine tonsils are covered with a dirty yellow coating. A sore throat of a pressing character, swallowing is less difficult. The general condition suffers less than with follicular angina ( Fig. 4 ).

Sore throat clinic:

• sore throat of varying intensity (from minor pain when swallowing to severe pain in which it is difficult to eat),
• fever – febrile numbers,
• lymphadenitis – an increase in the cervical lymph nodes along the anterior surface of the sternocleidomastoid muscle.

Characterized by an acute onset, usually after hypothermia, first there is a sore throat and body temperature rises. The patient’s general condition suffers: muscle aches, weakness, headache.
Treatment of angina involves the use of systemic antibiotic therapy and local remedies.

When deciding on systemic antibiotic therapy, the following criteria are followed:

• febrile fever,
• inflammatory exudate in the lacunae of the tonsils,
• enlargement of the anterior cervical lymph nodes,
• absence of runny nose and cough,
• positive test for streptococcus.

The presence of two or three of the above criteria is an indication for the appointment of systemic antibiotic therapy [4].

When prescribing local therapy, the doctor is faced with a large selection of drugs. If you understand their diversity, then the following groups should be noted ( tab. 1 ):

• antiseptics,
• antibiotics,
• non-steroidal anti-inflammatory drugs,
• immunostimulants,
• herbal antiseptics.

Local therapy for moderate and severe angina is prescribed in addition to systemic antibiotic therapy. As monotherapy, topical drugs are used only for mild severity.

With angina, it is logical to prescribe antiseptics, antibiotics. With severe pain, nonsteroidal anti-inflammatory drugs are prescribed, but not more than 3 days, and the drugs have a daily limit of 4-5 times a day.

Infectious mononucleosis is an infectious disease caused by the Epstein-Barr virus, manifested by damage to the reticuloendothelial and lymphatic systems.

Symptoms of infectious mononucleosis:
• fever,
• tonsillitis ( fig. 5 ),
• polyadenitis – not only cervical lymph nodes increase, but also axillary and inguinal lymph nodes,
• enlargement of the liver and spleen,
• leukocytosis with a predominance of basophilic mononuclear cells.

The disease begins with fever and sore throat. The general condition in some cases suffers greatly.Patients complain of poor health, loss of energy, loss of appetite. Sore throat can be intense in adults. Then the lymph nodes increase, the fever is varied in nature and duration. Fever may return after a decrease in body temperature numbers. Patients who have received systemic antibiotic therapy, especially aminopenicillins, develop a rash. Therefore, for the early detection of infectious mononucleosis, it is necessary to conduct a general blood test, in which mononuclear cells can be detected, but this is not a specific reaction of the body.The increase in these cells can also be with other viral infections. It is necessary to use the detection of IgM in the blood, which is an indicator of the acute phase of the disease, appears simultaneously with clinical symptoms and persists for 1-2 months. IgG is found throughout life in all patients with infectious mononucleosis. His research is significant only for conducting epidemiological studies [5].

Antiseptics are the drugs of choice for the local treatment of infectious mononucleosis.

However, sore throat is not always caused by inflammatory diseases of the pharynx. A sore throat can be caused by chronic pharyngitis associated with laryngopharyngeal reflux (LFR). This term was proposed in 1991 by J. Koufman. Laryngopharyngeal reflux is the reverse flow of fluid from the gastrointestinal tract to the mucous membrane of the larynx and pharynx. This is the most common manifestation of extraesophageal reflux [1].

Clinical manifestations of LFR:

• sore throat,
• feeling of a foreign body or “lump” that the patient cannot swallow,
• constant coughing,
• an abundance of mucus in the oropharynx and laryngopharynx,
• plaque in the tongue,
• bleeding gums,
• aft,
• imprints of teeth on the tongue,
• discrepancy between the severity of the symptoms presented by the patient (for example, very severe sore throat) and the pharyngoscopic picture,
• symptoms associated with discomfort in the ears, which are not objectively recorded (from “popping” in the ears to ear congestion),
• inconsistency in the severity of symptoms from the larynx, hoarseness up to aphonia and a laryngoscopic picture,
• ineffectiveness of systemic antibiotic therapy for sore throat.

If the sore throat is not very intense, there is more perspiration, sometimes it is accompanied by a cough and the above clinical symptoms are observed, then we can talk about LFR. To clarify the diagnosis, it is possible to conduct a questionnaire survey of the patient. The Reflux Symptom Index (J. Koufman) questionnaire has been translated into Russian, its validity has been proven, and the questionnaire is highly sensitive. The patient needs to evaluate the following symptoms: 0 – no symptom, 5 – painful as much as you can imagine ( tab.2 ).

All points are summed up, and, depending on the amount, the data obtained are interpreted: from 0 to 9 points – reflux of gastric contents into the larynx and esophagus was doubtful and is not taken into account in the treatment of this patient; from 9 to 13 points – the diagnosis of GERD is probable and requires confirmation by additional clinical methods; with a total of more than 13 points, the diagnosis of ENT form of GERD is regarded as undoubted.

Prescribing antiseptic and antibacterial drugs to patients who have more than 13 points on the ISR questionnaire not only does not help, but also causes a worsening of the condition and intensification of symptoms. Such patients should be referred to a gastroenterologist. Antacids are emergency drugs for these patients.

Here is a clinical example from the practice of Dr.N. Romanova, Ph.D., who shows the value of culture culture from palatine tonsils. Patient M., 40 years old, turned to an otorhinolaryngologist for help with sore throat. Pharyngoscopy revealed purulent deposits on the tonsils ( Fig. 7 ). Protected penicillin was prescribed as the first line of empiric administration of systemic antibiotics. The weekly course of this antibiotic was not successful, but by the time the course of treatment was evaluated, the culture of the tonsils was ready and it was revealed that the angina was caused by Pseudomonas aeruginosa (an extremely rare situation).With the appointment of a course of ciprofloxacin, angina in this patient was resolved.

Thus, sore throat does not always occur with inflammatory diseases of the oropharynx. The doctor at the reception should not forget:

• about carrying out streptotest for all acute conditions of the oropharynx,
• carrying out culture inoculation from the palatine tonsils with angina,
• conducting a survey using the ISR,
• conducting a general blood test,
• conducting a general analysis of urine (to exclude generalized streptococcal infections),
• conducting a biochemical blood test (antistreptolysin O, C-reactive protein, rheumatoid factor).

Careful implementation of all points of the above algorithm is important to achieve good treatment results and prevent complications.

References

1. Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 1991, 101 (53): 1-78.
2. Lund VJ, Grouin JM, Eccles R, Bouter C, Chabolle F. Efficacy of fusafungine in acute rhinopharyngitis: a pooled analysis. Rhinology 2004, 42 (4): 207-212.
3. Bartlett J. Respiratory tract infections. Per. from English M .: Binom, 2000: 192.
4. Shpynev K.V., Krechikov V.A. Modern approaches to the diagnosis of streptococcal pharyngitis. KMAKH, 2007, 9 (1).
5. Shuvalova E.P. Infectious diseases: textbook. M .: Medicine, 2005.

Source: Medical Council, No. 15, 2014

Could your sore throat cause “silent reflux”?

December 12, 2014

Despite its name, silent reflux, also known as laryngopharyngeal reflux (LRF), is something other than quiet. A condition that causes irritation and sore throat is called silent reflux because it often lacks the symptom of the hallmark

Gerd and Typical Sour Reflux

– heartburn.

Despite the absence of heartburn, many people with LPR report a wide range of symptoms due to acid damage, causing their voice box, respiratory system, teeth, and throat.

“Reflux can be what we call extra-esophageal,” notes

Michael Vaezi, MD, PhD

, Clinical Director of the Division of Gastroenterology and Hepatology and Director of the Center for Esophageal Motility Disorders at Vanderbilt University in Nashville, Tenn. “These patients may not have heartburn in their breasts. It is not very quiet, [but] presenting it is atypical. ”

Not so quiet symptoms

If you have LPR, you can experience:

• 
  Hoarseness.
  As stomach acid builds up on your voice box, or Larynx, you may find your voice sounds more hoarse or harsh than usual. This symptom can be especially noticeable in the morning, as acid often rises up your throat more often when you lie down.
• 
  Throat problems.
  
  Acid reflux in
  
  headlights
  
  or the back of the throat can also cause atypical symptoms. You may feel as if you constantly have
  
  sore throat
  
  or you always need to clear your throat.Also, it may feel as if there is a lump in the back of the throat that will not go away. Other symptoms include frequent hiccups, trouble, swallowing or carrying
  
  cough
  
  Refusal
• 
  Respiratory problems.
  
  People with silent reflux may experience
  
  wheezing
  
  or difficulty catching breath as a result of respiratory irritation from acid reflux. LPR can often exacerbate
  
  Primary asthma
  
  and complicate treatment.
• 
  Caries.
  
  Stomach acid that returns to the mouth can break down or eat up on the protective enamel of the teeth, causing brittle and discolored teeth.

Related: 7 Surprising Facts About GERD and Acid Reflux

Treat silent reflux

If your doctor suspects LPR may order some tests to confirm your diagnosis and determine which treatment option is best for you.These tests include:

• 
  Swallow Wade.
  
  This test includes a series of upper X-rays
  
  gastrointestinal
  
  System or digestive tract performed after the patient drinks a special barium solution. Contrast solution allows physicians to assess the digestive tract for structural problems that may be associated with LPR.
• 
  Endoscopy.
  
  Doctors insert a lighted tube attached to a small camera down the throat.The tube is used to examine the larynx, swallowing, and esophagus for signs of damage consistent with acid reflux. Tissue samples are usually accepted for laboratory testing for any evidence of chronic irritation, inflammation, infection, or abnormal cells.
• 
  PH monitoring.
  
  A thin tube is inserted through the patient’s nose and down into the esophagus. A device at the end of the tube measures the acidity, or pH, of the inside of the esophagus over a period of one to two days.Alternatively, the capsule is attached to the wall of the esophagus by

  monitor pH levels

  Failure The capsule is then detached and passed through the patient’s digestive system. Abnormally high levels of acidity are suggestive of decision-makers.

• 
  Proton pump inhibitor.
  
  Your doctor may try to diagnose your problem by treating you with a test.
  
  proton pump inhibitors
  
  which reduce the amount of acid secreted by the stomach.If your symptoms improve or disappear with medication, then you most likely have a DMD.

Silent Refrance is most commonly treated with proton pump inhibitors such as

Nontium

(

esomeprazole

),

Protonix

(

pantoprazole

),

Distribute

(

Lansoprazole

),

Aciphex.

(

Rabeprazole

), or

Prilotsei

(

Omeprazole

).

Lifestyle changes can also help reduce the symptoms of DMD. Your doctor may recommend:

• 
  Quit smoking
  
• Avoid alcohol
• Eliminate caffeine
• Slimming
• Numbing food three hours before bed
• Raise the head of your bed four to six inches
• Avoiding restrictive clothing
• Modifying dietary changes (foods that are fatty, fried, spicy, or include mint or chocolate) must be avoided

In some cases, DM symptoms may persist despite lifestyle changes and medications.In these cases, surgery may be recommended to tighten the lower esophageal sphincter.

Although LPR is an inconvenient and potentially serious condition, a correct diagnosis can control symptoms and avoid complications.

90,000 Could you be at risk for esophagitis?

April 13, 2018

Heartburn,

gastroesophageal reflux disease

(

Gerd

), and esophagitis can have a complex, intertwined relationship.

“Esophagitis simply means inflammation of the esophagus,” says

Stella Y. Chow, MD

, director of gastroenterology at the Lahi Clinic in Burlington, Massachusetts.

Your esophagus is the tube that connects your throat to your stomach. When your esophagus becomes irritated or swollen, it causes symptoms of esophagitis. Heartburn, a common symptom of esophagitis, affects nearly 40 percent of Americans at least twice a month, but occasional heartburn doesn’t necessarily mean you have esophagitis.

Gerd, which affects about 20 percent of people in the United States, is a more serious form of regular and frequent heartburn that is more likely to lead to esophagitis. GERD occurs when stomach acid spills from the stomach and travels up into your esophagus, a condition called reflux. Since the lining of your esophagus is not designed to be tolerated by stomach acid, the acid causes irritation and swelling inside your esophagus.

Common causes of esophagitis

It is not always clear why some people have a lot of acid reflux, but it could be due to a weakness in the muscles that hold the acid inside the stomach, called

hiatal hernia

Refusal

“Esophagitis from acid reflux can be mild, or it can be quite severe.Over time, acid reflux can cause swelling or stiffness in the esophagus, which interferes with swallowing, ”says Dr. Chau.

“GERD is the most common cause of esophagitis, but other conditions can also cause esophagitis,” explains Chow. This includes:

• 
  Esophagitis pills
  
  “This condition can arise from swallowing pills that irritate your esophagus. Common examples include
  
  antibiotic doxycycline
  
  and
  
  potassium
  
  Pills, Chow says.Esophagitis tablets can also occur when you swallow the tablets without drinking enough water.
• 
  Esophageal infection
  
  
  Yeast infections
  
  , fungal infections, bacterial infections, and some viral infections can cause esophagitis.
• 
  Eosinophilic esophagitis.
  
  Approximately 56.7 out of 100,000 people are diagnosed with esinophilic esophagitis in the United States, according to

  Study published April 2014 in

  Clinical gastroenterology and hepatology

  Refusal
  
  “This is a rare type
  
  allergic reaction
  
  This causes inflammation of the esophagus, says Chow.Foods such as milk, eggs, wheat, soy, peanuts, beans, rye, and beef can cause this form of esophagitis, according to

  Mayo Clinic

  Refusal

• 
  Other reasons
  
  These include irritation from excessive vomiting due to illness or
  
  bulimia
  
  , alcohol, caffeine, cigarette smoking, or heartburn causing medications such as
  
  aspirin
  
  or anti-inflammatory.

Heartburn and other symptoms of esophagitis

Heartburn

or acid

consideration disorder

May be the most common symptom of esophagitis.Heartburn can occur after eating, especially when lying down, and can cause burning in your chest or throat and a bitter taste in your mouth.

Other symptoms of esophagitis may include:

• Difficulty or painful swallowing
• Chest pain
• 
  Cough
  
• Food blue
• Acid regurgitation
• Chronic hoarseness
• 
  Sore throat
  

All of these symptoms can also be caused by other conditions, so you should see your doctor to determine the cause.Don’t assume they are all due to esophagitis. In children and infants, feeding difficulties and inability to thrive may have signs of esophagitis, according to

Mayo Clinic

Refusal

How is esophagitis diagnosed?

A diagnosis of esophagitis begins with a history and physical exam, Chow explains. “If your doctor thinks you might have esophagitis, you probably need a special type of imaging exam. You may also need a special exam to look inside your esophagus, called an endoscopy. “

Diagnostic tests include:

• 
  Esophageal manometry
  

  A thin, pressure-sensitive tube is passed through your nose and into your esophagus to measure the pressure and pattern of muscle contractions in your esophagus.

• 
  Barian swallow
  
  This imaging study takes
  
  X-ray
  
  Image of your esophagus after you drink barium solution.Barium coats inside the esophagus reveal any constriction from esophagitis.
• 
  Endoscopy
  
  During this procedure, your doctor examines your esophagus through a flexible, lighted tube. The tube is inserted through the mouth and requires light anesthesia.
• 
  Biopsy
  
  During an endoscopic procedure, doctors often remove a piece of tissue from the esophagus, which should be viewed under a microscope for signs of inflammation.

Tips to Avoid Esophagitis

“Some things you can do to prevent GERD symptoms of esophagitis include seizures

antacids

avoiding food near sleep,

slimming

, do not wear tight-fitting clothing, do not smoke, but cut into alcohol, spicy foods and caffeine, “suggests Chow.

Untreated esophagitis can lead to serious complications, including changes in the structure of the esophagus and rupture of esophageal tissue, and may even increase the risk of developing esophageal cancer, according to

Mayo Clinic

Withdrawal You can reduce the risks of these complications by staying away from identified triggers. Healthy people usually recover within three to five days, but those with weakened immune systems may take longer from an episode of GERD with esophagitis to heal.

If you have symptoms of esophagitis that occur more than twice a week, they do not seem to respond to coming of age

antacid

Medications, the symptoms are so severe that it is difficult to eat, or if the symptoms are accompanied by headache, fever and muscle pain, you should see your doctor. Esophagitis symptoms such as food stuck in your throat, pain when swallowing, and weight loss need to be further investigated.

Additional reporting by ERICA TRICARICO.

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90,000 Symptoms of gastroesophageal reflux disease (GERD)

Heartburn and acid regurgitation are the main symptoms of gastroesophageal reflux disease (GERD) 1, although some people have GERD without heartburn.Other symptoms include chest and / or abdominal pain, difficulty swallowing, dry cough, hoarseness, nausea, vomiting, halitosis, wheezing, and interrupted sleep.

Frequent symptoms

Whether you have heartburn or not, if you have GERD, you are likely to experience some or all of these 2 common symptoms, including:

• Acid reflux: You may feel a burning sensation in your chest and / or abdomen, and you may taste stomach acid when combined with any food you have just eaten, especially in the back of your throat.This is because the valve between the stomach and the esophagus that carries food from the mouth to the stomach does not close properly and allows stomach contents to move in the wrong direction, back to your mouth.

• Chest or abdominal pain: Usually begins behind the breastbone or sternum, may extend to the throat and spread to the back.4 You may also experience pain in the upper or middle abdomen. The pain usually occurs shortly after eating and can last from a few minutes to several hours.It is important to remember that sometimes the pain of a heart attack can be confused with the burning pain of GERD, and it is always important to seek medical attention if there is any doubt about the origin of your breasts.

• Hoarseness: Irritation caused by the flow of stomach acid down the throat can lead to hoarseness or laryngitis, especially in the morning.

• Difficulty swallowing: Problems with swallowing, known as dysphagia, occur when food does not pass normally from the mouth through the esophagus to the stomach.6 There may be a sensation of food sticking to the throat, pressure in the chest or burning after eating, or a choking sensation. Difficulty swallowing can be a sign of a variety of conditions, including erosive esophagitis and esophageal cancer, and should always be seen by a doctor.

• Persistent dry cough: Aspiration of reflux acid from the stomach can cause a cough.7 This cough can also cause a sore throat.

• Bad breath: This can happen when acid from the stomach gets into the throat and mouth.

• Wheezing: You may experience difficulty breathing or hear a wheezing sound when breathing.

• Nausea or vomiting: GERD can also cause nausea and / or regurgitation, which can lead to tooth wear from acidic gastric acid.

• Sleep problems: GERD can disrupt your sleep if symptoms are bothersome. 10

Symptoms in the Elderly

Elderly patients may not associate their symptoms with heartburn or GERD, as they may differ from what is considered typical for this disease.11 Usually, when we think about the symptoms of GERD, we think of heartburn. In older people, symptoms often appear in the mouth, throat, or lungs.

Symptoms that may occur in the throat include:

• Feeling of a lump in the throat or of food stuck in the throat.

• Difficulty swallowing (dysphagia)

• Chronic angina

• Respiratory symptoms such as cough and wheezing.

Elderly patients with certain chronic conditions are at higher risk of developing GERD.They may be taking medications that cause the NPS to relax, which can lead to acid reflux. These people also tend to have decreased saliva production, which is a problem as the alkaline nature of saliva can help neutralize acid. Saliva can also relieve heartburn by flushing the esophagus, helping to protect it from the acid that refluxes back into the stomach.

Less common symptoms

These symptoms are certainly not as common as the ones listed above, but they are worth knowing about so that you can report them to your doctor if they arise.You may not necessarily associate them with GERD.

• Frequent sore throat: When the contents of the stomach re-enter the throat, it can cause irritation and sore throat.

• Respiratory problems such as asthma, pneumonia, bronchitis or wheezing: Several studies indicate a significant association between GERD and asthma, chronic cough, and other lung conditions.

• Hoarse voice: Irritation from stomach acid up the throat is a common cause of chronic hoarseness (laryngitis) in adults.

Complications

Regardless of your age, if you experience heartburn two or more times a week, take note. This constant movement of acidic stomach contents back up into the esophagus can irritate the lining and complications can occur at any age if left untreated.

Barrett’s esophagus

Barrett’s esophagus is a condition in which the esophagus, the muscle tube that carries food and saliva from the mouth to the stomach, changes so that part of its mucous membrane is replaced by tissue similar to that normally found in the intestines.The complication of acid reflux does not have any specific symptoms, just the usual symptoms of GERD.

People with Barrett’s disease are 30 to 125 times more likely to develop esophageal cancer than those who do not, but less than 1 percent of people with Barrett’s esophagus develop this cancer. However, if you are diagnosed with Barrett’s esophagus, it is important to have regular examinations, usually an upper endoscopy and biopsy to look for precancerous and cancerous cells.

When it comes to treating Barrett’s esophagus, routine measures to reduce GERD symptoms such as lifestyle, diet, and medication can help relieve discomfort.16 When it comes to reversing the disease, there is currently no cure.

Esophageal cancer

GERD is a risk factor for esophageal cancer.17 Esophageal cancer tumors begin to grow in the lining of the esophagus, and if it grows large enough to break through the wall of the esophagus, it can spread to other parts of your body using the lymphatic system, such as your transport …

Esophageal cancer symptoms

• Difficulty and / or painful swallowing

• Unexplained weight loss

If you experience any of these symptoms of esophageal cancer in combination with acid reflux, talk to your gastroenterologist. Various treatment options are available.

Erosive esophagitis

When your esophagus becomes inflamed and swollen, it is called esophagitis. 18 Acid reflux is the most likely cause, although infection may also be the cause.The symptoms of esophagitis include pain when swallowing and a burning sensation in the esophagus.

Treatment for esophagitis depends on the cause. Medications such as proton pump inhibitors and h3 blockers may be prescribed if esophagitis is a complication of acid reflux. Antibiotics may be prescribed if an infection is causing the esophagitis.

Esophageal strictures

A complication of prolonged acid reflux can be esophageal stricture or gradual narrowing of the esophagus, which can lead to difficulty swallowing.19 One of the causes of esophageal strictures can be scar tissue that builds up in the esophagus. When the lining of the esophagus is damaged, such as when acid reflux occurs over an extended period of time, scarring can develop. Other causes of strictures can include infections and the ingestion of corrosive substances.

Respiratory problems

Because GERD can inhale stomach acid into the lungs, which can then irritate the lungs and throat, breathing problems may occur.20 Some of these are both symptoms and complications and include:

• Asthma, new or worsening, if you already have one

• Fluid in the lungs

• Laryngitis or hoarseness

• Sore throat

Nocturnal reflux

When symptoms of gastroesophageal reflux disease (GERD) occur at night, they can be more devastating than if they occurred during the day.21 Evening can set the stage for the following, which may increase the likelihood of nighttime heartburn problems:

• Sleep while lying on your back: Lying in bed, stomach acid can more easily enter the esophagus and stay there longer than when you are upright. 22 Even raising your head and shoulders six to eight inches will help keep your stomach acidic.

• Inability to drink or swallow every time an acid reflux episode occurs: When you have GERD and are awake during an acid reflux episode, you often rinse your mouth or swallow some liquid.Even swallowing saliva helps. When you sleep, when reflux acid gets into your esophagus or throat, you are not always aware of it and therefore do not take steps to flush out the acid.

• Increased risk of choking due to reflux of stomach contents: If reflux acid is in your throat and mouth, you can inhale it into the lungs.23 Once in the lungs, it can cause coughing and choking on the suction material. The acid can also cause the same damage to your lungs as it would when it was thrown into the esophagus.

When to see a doctor

If you experience frequent and / or severe heartburn, make an appointment with your doctor.24 If you are taking over-the-counter heartburn medications such as Prevacid or Prilosek more than twice a week, you should also talk to your doctor.

Guide to Discussion with Dr. GERD

Get our printable guide for your next doctor’s appointment to help you ask the right questions.

Send to yourself or your loved one.

Regardless of age, see your doctor immediately if you develop any of these symptoms:

• Vomiting in large quantities

• Persistent, violent or propelling vomiting

• Vomiting green or yellow, bloody or like coffee grounds.

• Difficulty breathing after vomiting

• Sore throat or mouth while eating

• Difficulty swallowing or painful swallowing

Frequently asked questions

How long do GERD symptoms last?

Symptoms of GERD, including heartburn, can last for several hours at a time.GERD is a chronic form of acid reflux that tends to recur more than twice a week for several weeks or more. Acid reflux episodes will tend to recur if not prevented with medication or lifestyle changes.

How is GERD Treated?

Your doctor will suggest treatment based on your symptoms. This may include:

• Diet and lifestyle changes, such as losing weight, cutting back on alcohol, and avoiding certain foods.

• Medicines such as antacids, h3 blockers and proton pump inhibitors.

• Surgery for cases that do not improve with lifestyle changes or medications

90,000 Effective ways to overcome dry throat based on causes

Content:

Medical Video: 213th Knowledge Seekers Workshop March 1, 2018

Dry and itchy throat can be caused by various reasons. Therefore, the best treatment should be based on the root of the problem.Below are the various causes of throat and how to deal with dry throat.

How to deal with a dry throat, depending on the cause

1. Allergic rhinitis

Allergy to rhinitis is a group of symptoms including a runny nose, sneezing, cough, dry throat and itchy eyes, resulting from exposure to an allergic trigger. For example, dust or animal hair.

Symptoms of allergic rhinitis can be treated with:

• Take antihistamines to treat allergies.
• Allergic shots given by doctors with the use of an antihistamine do not improve.
• Take a decongestant to relieve a stuffy nose.
• Drink warm ginger tea to ease your throat because ginger has anti-inflammatory properties.
• Chew garlic because garlic has an antihistamine effect.
• Chew onions because they are anti-inflammatory and contain antioxidants.

2.Dehydration

Dry throat for no reason, which could clearly be a sign that you are drinking less. A body that lacks fluids cannot produce large amounts of saliva to treat the mouth and throat.

To overcome dry throat due to dehydration, you can simply drink water until your throat gets better. Also, try to meet your fluid needs so that your body does not become dehydrated, which can make your throat dry, dizzy, and weak.Fruit juice, mineral water, and coconut water are good sources of water for throat relief. Avoid sodas and caffeine because this can cause your body to lose more water.

3. Sleep with your mouth open

Not much, sleeping with your mouth open can also cause a dry throat, especially when you wake up in the morning. This is because the night air, which tends to dry out, will dry out the saliva that normally permeates the mouth and throat.Not only do you have a dry throat, but you also have bad breath.

Usually people who sleep with snoring and runny nose tend to sleep with their mouths open.

To fix this, you can use the fence in the following ways:

• Take decongestant medicine.
• Take medicines that contain antihistamines.
• Use a corticosteroid nasal spray.

4. Colds and flu

Colds and flu can cause a dry and itchy throat.In addition, you also usually experience a number of typical symptoms such as mild fever, coughing, sneezing, and pain.

To deal with dry throat from colds and flu, you can use the following methods, such as:

• Drink plenty of water to keep your body hydrated.
• Get enough rest.
• Gargle with warm water or salt water.
• Take a decongestant medicine.
• Inhaling warm steam, which can help relieve nasal congestion and sore throat.
• Squeeze your forehead and nose with warm water.
• Drink warm water.

5. GERD

GERD causes acid side to the esophagus. One of the symptoms of GERD is dry and itchy throat, dry cough, difficulty swallowing, burning and burning in the chest until a hoarse voice.

To cope with dry throat due to GERD, you need to treat GERD itself:

• Take antacids to neutralize stomach acid.
• Take H2 inhibitors such as cimetidine (Tagamet HB), famotidine (Pepcid AC), ranitidine (Zantac) to reduce stomach acid production.
• Raise your head with a pillow while sleeping to prevent acid from entering your esophagus and throat.
• Avoid foods that cause a burning sensation in the stomach, such as spicy foods that contain caffeine, peppermint and garlic.
• Wearing loose clothing to prevent stomach strain may increase the flow of stomach acid into the esophagus.
• Give a break of 1-2 hours after eating if you want to sleep.

6. Sore throat (pharyngitis)

Sore throat (pharyngitis) is a throat infection caused by a virus or bacteria.Usually, the throat not only hurts, but also dries. Also accompanied by symptoms of fever, cough and difficulty swallowing.

To overcome dry throat due to sore throat, you can do this:

• Take antibiotics by your doctor to kill bacteria.
• Gargle with warm water or salt water.
• Take an over-the-counter pain reliever such as ibuprofen or paracetamol.
• Lollipop

7. Inflammation of the tonsils

Inflammation of the tonsils can be caused by viral or bacterial infections.In addition to fever and difficulty swallowing, tonsillitis can also cause a dry, itchy throat.

To overcome this, you can try different ways, such as:

• Drink plenty of fluids. Warm drinks like tea or soup can help relieve your throat.
• Gargle with warm water and salt water several times a day.
• Take an over-the-counter pain reliever such as fibrofen or paracetamol.
• Rest until you feel better.
• Lollipop

8. Mononucleosis

Mononucleosis is a viral infection that spreads through saliva. One of the typical symptoms of this condition is itchy and dry throat. Below are the different ways to overcome mononucleosis, namely:

• Get enough rest.
• Take over-the-counter pain relievers, such as acetaminophen (Tylenol) or ibuprofen (Advil), to reduce fever and relieve sore throats.