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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

Recent News

SuperUser Account
/ Categories: News

Food Allergies and Theme Parks

By Eve Chen, USA TODAY

There’s a lot more to theme park food than funnel cakes and turkey legs. Many parks pride themselves on their array of dining options for guests, but not just for flavor. More than 6% of Americans have a food allergy, according to the Centers for Disease Control and Prevention’s National Center for Health Statistics. The most common food allergens are milk, eggs, fish, crustacean shellfish, tree nuts, peanuts, wheat, soybeans and sesame, according to the U.S. Food and Drug Administration. With those, allergy-safe options can be a matter of life and death.

“I had my first reaction when I was a baby to nuts, and I’ve had serious reactions since that have brought me to the ER – thankfully not too many in recent years,” said Allie Bahn, who helps travelers with food allergies through her Miss Allergic Reactor website and Allergy Travels Facebook group. Bahn has four of the top nine food allergies and other specific allergens, like potatoes. “It can be certainly life-threatening, so it’s different than avoiding foods just because of something bothering your stomach.”

Here are seven ways travelers with food allergies can safely navigate theme parks and what parks are doing to help:

Do your research.

Some parks flag top allergens on their websites and apps.

“It’s listed by restaurant, by item, and it talks about each item what would be the allergen that could be present in that item … A lot of folks who have been living with allergies know what they can and can’t eat, and they’re just looking for a map of ‘Where can I get what I need?’ ” said Cedar Fair corporate chef Charles Walker, who helped roll out new dietary guides for guests earlier this year. As someone with food allergies himself and family members with food allergies, Walker added, “This was near and dear to my heart to really make sure this guest-facing platform was very user-friendly.”

For more personalized help, Cedar Fair’s parks and many others have phone lines and email addresses listed on their websites just for guests with special dietary needs.

“I’m a big fan of contacting places ahead of time,” Bahn said.

Don’t go hungry.

Bahn recommends eating a hearty meal before heading to the park. “So you already have something nice and warm in your stomach, hoping that you’ll be able to find something (else) when you’re there,” she said. She also recommends having plans for a meal after leaving the park, so at least those two meals are covered.

Pack snacks. Not all parks allow outside food, but when permitted, Bahn recommends packing snacks for backup. “Don’t make assumptions that you definitely can’t eat. I think there’s always the ability to try to do as much research ahead of time and then see how it goes once you get there, but having a plan in place is always really helpful,” she said.

Always carry medication or epinephrine. Bahn says she’s carried an epinephrine auto-injector with her for as long as she can remember. “Don’t lock it up in a locker where you can’t quickly access it in case of an emergency,” she said. “It should be on you at all times.”

Ask questions.

“Ask if they have ingredients that you can see,” Bahn said. Some park restaurants have binders of ingredients guests can look at, but it’s best to confirm everything is up to date with chefs, who are happy to speak with guests with food allergies. Sometimes, when creating menus, chefs will intentionally avoid using common allergens like peanuts to make foods more accessible. Chefs can also sometimes adjust dishes for allergies.

“Our festival chefs will go through (the menu) and make sure, based off of the dietary needs, if a dish is safe, if there’s anything (the guest) can have from those kiosks, or if there’s a way, we can make that dish for them safe,” said Kevin Downing, executive chef of EPCOT Festivals at Walt Disney World. Cedar Fair’s Walker echoed, “If you have a very, very specific allergy, we’ll do whatever we can to accommodate.”

Advocate for yourself.

“Explain your food allergies. Advocate for yourself,” Bahn said. She recommends carrying a Chef Card that can be given to chefs, stating each allergy, its severity, and the need for clean utensils and surfaces to be used in food preparation to avoid possible cross-contamination. “It makes everybody’s life, I think, a lot easier and really gets the point across that this is a severe food allergy and not just dietary preference,” she said.

When an allergy-related order comes into Connections Eatery kitchen at EPCOT, Chef Scott Tosh said. “It prints up special, so the special diets-trained cast member will prepare that food. We put an allergy pick in it. If there’s two items – one’s allergy, one’s not – we serve them with separate trays.” Bahn said Disney parks have always been great with her needs, even when she was a kid and people were generally less aware of food allergies.

Trust your gut.

Bahn recommends double-checking all food before digging in.

“I think I have been able to sort of save myself from some potential reactions because of advocating and double checking, trusting my gut,” Bahn said of no place in particular. “There’s plenty of times where I’ve decided not to eat, even if I’ve ordered something because I just felt like I didn’t get all my questions answered in a way that I felt was safe. And that’s OK too. Being able to politely and kindly decide not to eat and walk away and make a different plan is OK, as well. It’s your safety. It’s your health.”

https://www.usatoday.com/story/travel/experience/theme-parks/2023/12/14/food-allergies-theme-park-tips/70911517007/

The post Food Allergies and Theme Parks appeared first on Oklahoma Allergy and Asthma Clinic.

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