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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
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New Year’s Resolutions for Asthma and Allergies

Source: Asthma and Allergy Network

Tips to help you gain better control

Are you tired of your nagging cough or runny nose? Does the thought of spring flowers immediately make you want to sneeze? Are you looking for new ways to eat healthy despite your food allergies?

Take control of your allergies and asthma in the new year. No more sleepless nights and red, itchy eyes. No more sitting on the sidelines due to your asthma. Step up to better breathing with these New Year’s tips:

1 – Make a wish list

What would you like to be able to do if asthma or allergies didn’t hold you back? Ask yourself if there is anything that you’ve been avoiding because of your allergies or asthma that you usually enjoy doing.

2 – Review your treatment plan

Schedule an appointment with your doctor apart from an emergency or acute care visit. Share your wish list and ask if there are ways to reach your goals. There is no one, perfect way to treat allergies and asthma. Shared decision making is the key to a successful outcome: Work with your doctor to find the plan that works best for you.

  • Talk with your doctor about what is and is not working with your plan. Be honest about lifestyle and economic barriers you face. Are there medication side effects you’re worried about?
  • Take your medications to the appointment and review each one with your healthcare team: Why is it prescribed? When should you take it? How much should you take? How quickly should you expect results? What should you do if you don’t think it’s working?
  • If you use an inhaler, review your inhaler technique with your healthcare team. The medication can’t work if it doesn’t get into the lungs where it belongs.
  • Do you have a written Asthma Action Plan or an Allergy and Anaphylaxis Emergency Plan? If not, ask for one.

3 – Clean your indoor air

Change or clean air filters in your heating and air conditioning system. Vacuum carpets and corners regularly to keep dust and allergens down. Consider dust-mite proof pillow and mattress encasings and an air purifier if you have pets or mold. Keep pets out of the bedroom.

4 – Plan ahead

For seasonal allergies, begin using your allergy medication 3-4 weeks before your symptoms usually appear. The earliest tree allergens are from mountain cedars, which can peak in Texas and the southwest in January; in other parts of the country tree and grass allergens typically arrive in February and March.

5 – Prevent flares

Take care of yourself. Stop smoking and stay away from smokers; go to bed one hour earlier; get plenty of exercise; eat healthy foods; drink plenty of water per day – at least 2 liters if you do not have a medical condition prohibiting this – as staying hydrated keeps mucus from forming and prevents illnesses; get the flu shot and wash your hands regularly to avoid flu and cold viruses; and use nasal washes to keep your sinuses clean and flush out germs before they take hold.

6 – Follow up

Start a daily symptom diary online or in a notebook. Track your medication use, activities and symptoms; review it at your next appointment with your healthcare provider.

7 – Be reliable and proactive

Keep the appointment! See a board-certified allergist if your treatment plan isn’t working. Practice preventive care – healthcare should be a priority even when you are not sick.

The post New Year’s Resolutions for Asthma and Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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