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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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OKC named 4th most challenging city for spring allergies

3-15-2023 – Today, the Asthma and Allergy Foundation of America (AAFA) released its annual Allergy Capitals™ report for 2023. The report identifies the most challenging cities for pollen allergies in the 100 most populated metropolitan areas in the continental United States. Cities are ranked based on tree, grass, and weed pollen scores, over-the-counter allergy medicine use, and availability of board-certified allergists/immunologists.

Oklahoma City was ranked fourth and Tulsa was fifth. Wichita, Kansas, took the top spot based on its high tree and grass pollen scores, higher-than-average use of allergy medicines, and limited number of allergy/immunology specialists per patient.

The top 20 Allergy Capitals for 2023 are 1. Wichita, KS; 2. Dallas, TX; 3. Scranton, PA; 4. Oklahoma City, OK; 5. Tulsa, OK; 6. Sarasota, FL; 7. Cape Coral, FL; 8. Orlando, FL; 9. Des Moines, IA and 10. Greenville, SC.  Oklahoma was sixth in 2022 while Tulsa was 21st.

AAFA began identifying annual Allergy Capitals 20 years ago in 2003. Since that first report, pollen counts have worsened. This year’s report once again highlights the significant impact that climate change has on public health – specifically, for people with pollen allergies. Rising temperatures result in longer growing seasons, leading to higher pollen concentrations in many areas of the country.

“We are experiencing longer and more intense allergy seasons because of climate change. For people with asthma, allergies can trigger an asthma attack,” says Kenneth Mendez, CEO and president of AAFA. “About 81 million people in the U.S. have seasonal allergic rhinitis, which is most often caused by pollen allergies. If we don’t take immediate action on the climate crisis, pollen production will only intensify. This means more allergy and asthma attacks and additional strain on our health systems.”

The National Climate Assessment from the U.S. Global Change Research Program confirms that climate change is a major threat to public health. Longer and more intense pollen seasons caused by climate change particularly impact people with allergies and asthma. From 1990-2018, the plant-growing season extended an average of 20 days and produces about 21 percent more pollen, putting people with pollen allergies at risk of more symptoms for longer periods. Allergies can also trigger asthma episodes or attacks. Around 60-80 percent of the nearly 26 million people in the U.S. with asthma have allergic asthma.

“As pollen counts spike, we often see spikes in emergency room visits for asthma,” Mendez says. “Around 3,600 people per year die from asthma, so it is important to address and manage asthma and allergy triggers where you live.”

Black, Hispanic, and Indigenous populations bear the disproportionate burden of air pollution, asthma, allergies, and climate change. This is the result of a long history of discriminatory housing and environmental policies in the U.S. that have pushed people of color to live in undesirable neighborhoods with greater environmental and social risks. As a result of systemic racism in U.S. policies, governance, and culture, racial and ethnic minority populations are more vulnerable to the health impacts of climate change.

“AAFA’s Allergy Capitals™ report serves as a national call-to-action on climate change due to its impacts on individual and community health,” says Melanie Carver, chief mission officer of AAFA. “While there are steps individuals can take to manage their symptoms, it is imperative for communities to build their climate resiliency, improve their city planning, and take action on health disparities impacting higher risk populations.”

For people who are impacted by pollen allergies, there are options available to prevent or treat allergy symptoms. Treatment options include over-the-counter or prescription allergy medicines. Medications are most effective when started before a person’s allergy season begins.

“The Oklahoma City area has pollen all four seasons of the year, so many allergy sufferers don’t get much of a break,” said Bret Haymore, MD, board-certified allergist with the Oklahoma Allergy & Asthma Clinic.

Haymore recommends seeing an allergist who can find out what your allergy triggers are and make a treatment plan to best help manage them.

For more information, visit the OAAC website at www.oklahomaallergy.com to view the addresses for all Oklahoma Allergy and Asthma Clinic locations.  To make an initial appointment or to request more information, please call (405) 235-0040.

Spring Allergy Chart

 

The post OKC named 4th most challenging city for spring allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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