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Acid Reflux

Acid reflux or GERD occurs when gas, liquid or food particles in the stomach return back up the esophagus (food tube) into the back of the throat (pharynx), mouth, nose, sinuses, middle ear tube (Eustachian tube), or middle ear. This results in irritation (inflammation) and discomfort of these areas. It is important to note that patients don’t always feel the irritation and the symptoms can be ‘silent’. When this occurs, your doctor might see evidence on your physical exam or note other symptoms that are concerning for reflux.

When the reflux enters the upper airway, it is called laryngeal pharyngeal reflux or LPR. When this occurs, it is called GERD/LPR. Unfortunately, up to 60% of the population will have reflux one or more times per week.

As many as 75% of individuals with asthma are at a higher risk of experiencing acid reflux symptoms. In fact, asthmatics are twice as likely to have GERD. Many severe asthmatics have GERD that makes their asthma more challenging to treat. The stomach contents may trigger nerves associated with asthma (particularly cough) or can actually enter the airways (aspiration) resulting in spasm, irritation and asthma symptoms. For these reasons, reflux needs to be considered in individuals with asthma.

Signs and Symptoms of GERD/LPR

  • Nasal congestion and sometimes runny nose
  • Postnasal drainage
  • Cough
  • Hoarseness (particularly in the morning), throat irritation/burning
  • Unusual or bitter taste in the mouth or the back of the throat (brackish water)
  • Difficulty swallowing or choking (particularly at night)  Recurrent sore throat, pneumonia, bronchitis, sinusitis, or ear infections
  • Constant throat clearing
  • Bad breath (halitosis)
  • Burning chest pain (can mimic heart attacks)
  • Abdominal fullness, gas, or belching after meals
  • Chest pain, burning or tightness in the chest after lying down or bending over

If GERD/LPR is diagnosed, your physician may recommend using medications to help block the effects of acid secretion. Anti-acids (like Rolaids or Tums) weaken and neutralize the acid in your stomach, but don’t affect the production of acid and don’t work to prevent symptoms. H2 blockers (like Zantac or Pepcid) lessen the production of acid in your stomach and help prevent symptoms. They tend to work longer but are not quick to act so they don’t alleviate symptoms quickly. Proton Pump Inhibitors or PPIs (like Prilosec, omeprazole or Nexium) are longer acting and make acid less prevalent in the gut. They work by preventing symptoms and must be taken on an empty stomach 30 minutes prior to eating.

All medications including those for acid reflux have potential side effects and these can be discussed with your provider.

Measures That May Help Alleviate Symptoms of GERD/LPR:

  • Elevate the head of your bed 6-8 inches (This can be done by placing the top bedposts on cinder blocks or using a wedge under the top of the mattress. Elevating your head on pillows is not as effective.)  Eat smaller, more frequent meals rather than large ones.
  • No eating or drinking at least 3-4 hours before bedtime.
  • Drinking fluids of any type before bedtime can result in stretching the stomach opening resulting in reflux.
  • Do not skip meals. This can actually result in a 15% increase in daily caloric intake. Skipping meals usually result in overeating of the remaining meals, which can overfill your stomach and increase acid reflux.
  • Lose weight, if needed. We know that those who are overweight do not respond as well to GERD meds as those who are of healthy weight.
  • Avoid bending over, straining, constipation or wearing tight clothes around the abdomen.

Eliminate the following foods and beverages (totally, if all possible)

  • Caffeinated and/or decaffeinated products
  • Alcohol
  • Carbonated beverages of any type
  • Chocolate
  • Mint (includes gums and toothpaste)
  • All types of citrus
  • Fried foods (includes many spicy or fatty foods)
  • Nicotine of any type
  • Dairy

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Do you have the winter sniffles?

5 ways you can manage indoor winter allergies

Do you suffer from itchy eyes, a runny nose or a scratchy throat during winter? Do you often find yourself coughing, sneezing and having trouble breathing? Chances are you may have indoor allergies.

Allergens are not just found outside in trees or grass. The indoors can host many triggers like mold in pipes, pet allergens, and dust mite and cockroach allergens.

Indoor allergies are a year-round problem, but you’ll notice them more during the winter because you spend more time at home. Also, because of the colder weather, you’re likely keeping doors and windows shut to keep the cold out. By doing that, you’re also sealing allergens indoors with you, and your heating system will recirculate the indoor air and any allergy triggers.

You don’t have to accept indoor allergies as an inevitable fact of the winter season. Using these five tips from the American College of Allergy, Asthma and Immunology (ACAAI), you can be proactive and manage your winter allergies.

1. Clean regularly
It may seem like a simple solution, but cleaning house is one of the easiest ways to deal with indoor winter allergies. Dust, mold, pet dander and dust mite and cockroach droppings can hide anywhere and cause sneezing, coughing and congestion.

To limit your exposure to these indoor allergens, keep a regular cleaning schedule. Dust and vacuum frequently, especially under and behind furniture, where allergens can easily build up. Wipe down counters and other surfaces that you use often. During the holidays, wipe off holiday decorations, especially if you’ve stored them in areas where dust and mold proliferate.

2. Reduce pet allergy triggers
It can be difficult to balance your love for your pets and indoor allergy management. Just like you, your pets are spending more time indoors, increasing your exposure to pet dander and saliva.

While you may enjoy snuggling with your pets before bed, keeping them out of the bedroom will help with any allergies you experience at night that can disrupt your sleep. During the day, keep the door to your bedroom closed, so your furry family members aren’t tempted to go in.

When petting your cat or dog, make sure to wash your hands afterward, so you don’t accidentally touch your face and provoke an allergic reaction. Finally, remember to groom your pets regularly to reduce indoor air allergens.

3. Protect your bedding from dust mites
According to the ACAAI, dust mites live and multiply in warm, humid places and are often found in pillows, mattresses, carpeting and upholstered furniture. Even if your home is visibly clean, dust mite allergen particles are too small to be seen.

Use mite-proof zippered cases for your mattress and pillows to limit your exposure to dust mites. Every week, wash and change your sheets, blankets and other bedding in hot water to eliminate any lingering dust mite droppings.

4. Find and prevent indoor mold
Did you know that there are roughly 1,000 species of mold in the U.S.? Many molds aren’t visible to the naked eye, and mold spores can cause allergic reactions when they become airborne. Because mold can grow in your basement, bathroom, under the sink and anywhere with running water, avoiding mold allergens can be difficult.

If you suspect you have indoor mold, it’s best to contact a professional who can find and clean up existing mold in your home. To prevent mold from growing inside your home, quickly stop and clean up any leaks. Also, make sure to reduce moisture and humidity in bathrooms and kitchens. If humidity control is a problem, consider a dehumidifier.

5. Find an allergist
Consulting an allergist is the best way to identify and treat your winter indoor allergies.

“Allergists are the best trained medical professionals to treat allergies and asthma,” said Kathleen May, MD, ACAAI president. “They can help you get tested, get treated and get better so you can enjoy the holiday season and beyond.”

After a consultation, your allergist may perform tests to diagnose your allergies and identify potential causes. An allergist can also prescribe antihistamines and other allergy treatments to give you relief from your allergic symptoms.

Using these five tips, you can better manage your indoor allergies this winter so you can enjoy the cozy colder months without suffering from allergies. 

About ACAAI
ACAAI is a professional medical organization of more than 6,000 allergists-immunologists and allied health professionals, headquartered in Arlington Heights, Ill. The College fosters a culture of collaboration and congeniality in which its members work together and with others toward the common goals of patient care, education, advocacy, and research. ACAAI allergists are board-certified physicians trained to diagnose allergies and asthma, administer, and provide patients with the best treatment outcomes. For more information and to find relief, talk to your OAAC provider.

The post Do you have the winter sniffles? appeared first on Oklahoma Allergy and Asthma Clinic.

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