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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

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Making Halloween Fun for Everyone

When a child has a food allergy, holidays can be especially tough for both the child and the child’s family, says Oklahoma Asthma & Allergy Clinic’s Board-Certified Allergist Dr. Maya Gharfeh.

“Holidays are such an important and fun part of childhood,” said Gharfeh. “One of the most important things of raising a child with a food allergy is to not let him or her feel different or isolated because of the food allergy. Instead, we adapt and still let the holiday be as fun as possible.”

The Teal Pumpkin project is an initiative created by the Food Allergy Research and Education (FARE) network to promote a safe Halloween for all including those with a food allergy. It encourages families to place a teal pumpkin on their doorstep to let families know they have non-food treats available for kids with food allergies. Those who wish to participate can register their home address on the FARE website so families can pre-plan their trick or treating.

Any food allergy is potentially life threatening. An accidental exposure through ingestion of a food allergen may quickly lead to a life-threatening situation where a child would need emergency medication – like epinephrine – for survival.

As the mother of a child with a food allergy, Gharfeh has first-hand knowledge. She suggested ideas they’ve done to make a happier Halloween for their daughter.

“We have a rule of no eating or snacking on candy while trick or treating. We go house to house and collect treats as normal. Once we get home, we dump them out and I sort the candies into safe and non-safe, specific for my daughter,” Gharfeh said.

She always keeps safe treats at home for a swap out for those unsafe ones.

“No one wants a half-full Halloween basket,” she said.

Non-food items for those swap outs could include stickers, glow in the dark bracelets and necklaces, Halloween pencils, spider rings, etc.

“Since my daughter has a nut allergy, we try to stay away from most of the chocolate candies and stick with sugar candies such as Skittles or Jolly Ranchers,” Gharfeh added. “We always carry our emergency epinephrine device with us while trick or treating to be ready for an emergency.”

Other ideas for making Halloween safer, Gharfeh says, includes hosting your own Halloween party with allergy safe food treats and non-food items as treats. She encourages families to educate their neighbors and friends about the Teal Pumpkin project. Volunteer for school positions to allow more involvement in choosing snacks/treats for holidays such as Halloween.

“Kids love painting pumpkins,” Gharfeh said. “By inviting your neighbors to participate, you have provided an opportunity to ensure some safe stops for your food allergic littles in your neighborhood.”

FARE recommends has these ideas to celebrate the teal pumpkin project:

  • Decorate your front door. Grab some teal plastic pumpkins (available at local retailers), festive decorations and transform your door. Get your whole neighborhood involved.
  • Host a virtual Halloween party. Staying inside this year? Plan a virtual party so kids can dress up and show off their costumes. Make the party even more interactive by playing fun games online like bingo or trivia.
  • Set up a craft and activity station and let the kids loose! From coloring sheets to word matches, FARE has printable resources for getting kids excited about Halloween.
  • Halloween Scavenger Hunt – get your kids outside and moving. Take a walk or drive around to try and spot sooky sights. Bonus points for spotting teal pumpkins.
  • Stay in for a scary movie night. Invite your friends and neighbors over to watch your favorite Halloween movie.
  • For food allergy friendly recipes, check out the FARE website www.foodallergy.org

If families suspect their child might have a food allergy, Gharfeh says, “Come see a board-certified allergist. We want to help not only diagnose but also to help you, your child, and your family know what a food allergy means and the steps to ensure a safe, healthy and fun childhood, even with a diagnosis of a food allergy.”Teal Pumpkin Campaign

 

The post Making Halloween Fun for Everyone appeared first on Oklahoma Allergy and Asthma Clinic.

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