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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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Oklahoma Allergy & Asthma Clinic Warns High Heat May Trigger Asthma Flare-Ups

Doctors urge residents to take precautions as extreme summer temperatures hit Oklahoma

With dangerous heat and humidity gripping Oklahoma and much of the Southern United States, the Oklahoma Allergy & Asthma Clinic is urging individuals with asthma and respiratory conditions to take extra precautions. According to clinic physicians, extreme heat can significantly worsen asthma symptoms and contribute to a rise in asthma related medical emergencies during the summer months.

“Oklahomans with asthma need to take summer heat seriously,” said Dr. Dean Atkinson, a board-certified allergist at the Oklahoma Allergy & Asthma Clinic. “High temperatures and humidity can combine with high pollen and high mold levels to create a perfect storm for asthma attacks.”

Excessive heat, often accompanied by high ozone levels, humidity, and stagnant air, poses multiple threats to individuals with asthma. According to the Centers for Disease Control and Prevention (CDC) and the American Lung Association, heat increases inflammation in the airways, while humidity can trap allergens like mold spores, dust mites, and pollen—making it harder to breathe and easier to trigger flare-ups.

“We see a clear uptick in asthma flare-ups during Oklahoma’s high heat index days,” added Atkinson. “Staying cool and following an asthma action plan are critical steps for staying safe.”

In Oklahoma, where summer temperatures often reach triple digits, local air quality can deteriorate rapidly. The Oklahoma region continues to experience “HIGH ALLERGY ALERT DAYS” and “Ozone Alert Days,” with elevated pollen, mold, and pollution levels that can exacerbate asthma symptoms, especially for children, seniors, and individuals with chronic lung disease.

TIPS TO HELP YOU BREATHE EASIER WHEN THE HEAT IS ON

To help residents protect their respiratory health, physicians at the Oklahoma Allergy & Asthma Clinic recommend the following five strategies during extreme heat:

1. Stay indoors in air-conditioned spaces, especially during peak heat and ozone hours (typically mid-afternoon).

2. Stay hydrated to help maintain healthy airway function.

3. Check the Daily Pollen and Mold Report and the Air Quality Index (AQI) and avoid strenuous outdoor activity on high alert days.

4. Follow your asthma action plan and keep quick-relief inhalers accessible at all times.

5. Minimize exposure to additional triggers, such as cigarette smoke, cleaning chemicals, and other pollutants.

“Children are especially vulnerable to the effects of extreme heat and poor air quality. Their lungs are still developing, and they tend to be more active outdoors, which increases their exposure to asthma triggers during high heat index days.” says Dr. Maya Gharfeh, another board-certified allergist at the Oklahoma Allergy & Asthma Clinic

The Oklahoma Allergy & Asthma Clinic encourages all asthma patients to review their action plans and speak with their healthcare providers about how to adjust medications or activity levels during extreme weather.

For more information about asthma care, pollen counts, and summer safety tips, visit www.oklahomaallergy.com or follow the clinic on social media.

About Oklahoma Allergy & Asthma Clinic

Founded in 1925, Oklahoma Allergy & Asthma clinic has a 100-year history of patient-focused, state-of-the-art allergy and asthma care. Today, the clinic is home to 13 allergy and asthma specialists, caring for tens of thousands of patients a year with a focus on evidence-based treatment, research, and patient education. To learn more, visit OklahomaAllergy.com.

The post Oklahoma Allergy & Asthma Clinic Warns High Heat May Trigger Asthma Flare-Ups appeared first on Oklahoma Allergy and Asthma Clinic.

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