Reflux

There are two types of acid reflux:
   

1.    GERD (Gastro-Esophageal Reflux Disease): Contents from the stomach return through the bottom esophageal sphincter and back into the esophagus. This causes swelling and irritation of the tissue in the esophagus. People with GERD feel like they have “heartburn” or indigestion. These symptoms become especially prominent when the person lies down.
2.    LPRD (Laryngo-Pharyngeal Reflux Disease): When reflux makes it all the way up through the top sphincter and into the back of the throat, it is called LPRD. The throat, voice box, and lungs are much more sensitive to stomach acid so smaller amounts of reflux into this area can result in more damage.

Why don’t I have heartburn or stomach problems?

People with LPRD rarely feel like they have heartburn or indigestion. In fact, approximately 70% of people with LPR do not report any heartburn at all. LPR can damage the throat without a person ever knowing it is happening.
Common Symptoms of laryngeal-pharyngeal reflux disease (LPRD) include:
    •    Hoarseness (may be most noticeable in the morning)
    •    Ongoing cough or chronic throat clearing
    •    Feeling of a lump or pain in the throat
    •    Problems swallowing
    •    Bad or bitter taste in the mouth (especially in the morning)
    •    Post-nasal drip
    •    Referred ear pain
    •    Asthma-like symptoms
    •    Singing: Difficulty with high notes: prolonged warm-up

How is LPRD diagnosed?

The 24-hour Pharyngeal-Esophageal pH monitoring is highly specific and sensitive to the accurate diagnosis of LPRD. A small tube is passed through the nose into the esophagus in order to monitor the amount and type of reflux during a typical day. This way, it can document if you have LPR as you go through your daily routine.

How do I treat and manage my reflux?

Reflux is managed with a combination of dietary modification, life-style modification, and medication. Your physician may prescribe medications, such as Pepcid, Zantac, Prilosec, Prevacid, or Nexium.

 

Dietary Modification

The following foods have been shown to increase reflux for many people:
    •    Spicy, acidic and tomato-based food
    •    Acidic fruit juices
    •    Caffeinated beverages
    •    Alcohol
    •    Tobacco
    •    Fatty foods
    •    Strongly flavored mints

 

Lifestyle Modification

The following habits may decrease the occurrence of reflux for many people:
    •    Avoid reclining right after meals
    •    Eat meals at least 3 hours before bedtime
    •    Elevate the head of your bed 4-6 inches with books, bricks, or a block of wood to achieve a 10-degree slant
    •    Avoid tight belts and other restrictive clothing
    •    Maintain a healthy body weight