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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

Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies
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Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies

The Asthma and Allergy Foundation of America (AAFA) released Feb. 23 its annual Allergy Capitals™ report for 2021 which identifies the most challenging cities for spring and fall allergies in the top 100 metropolitan areas in the United States. Oklahoma City was ranked ninth. Scranton, Pennsylvania took the top spot for 2021.

Cities are ranked based on three factors: spring and fall pollen scores, over-the-counter medicine use, and availability of board-certified allergists. Richmond, Virginia held the #1 title in 2020. The top 20 Allergy Capitals™ for 2021 are: 1. Scranton, Pennsylvania; 2. Richmond, Virginia; 3. Wichita, Kansas; 4. McAllen, Texas; 5. Pittsburgh, Pennsylvania; 6. Hartford, Connecticut; 7. Springfield, Massachusetts; 8. New Haven, Connecticut; 9. Oklahoma City, Oklahoma; 10. Bridgeport, Connecticut; 11. Albany, New York; 12. Virginia Beach, Virginia; 13. Buffalo, New York; 14. San Antonio, Texas; 15. Dayton, Ohio; 16. Riverside, California; 17. Las Vegas, Nevada; 18. Memphis, Tennessee; 19. Dallas, Texas; and 20. Louisville, Kentucky. Tulsa, Oklahoma was ranked 21.

“Allergies are a serious public health concern. More than 24 million people in the U.S. have seasonal allergic rhinitis, more commonly referred to as hay fever. Pollen allergies are a major cause. AAFA’s Allergy Capitals™ report helps more Americans make sense of the impact on individual and community health,” says Kenneth Mendez, CEO and president of AAFA. “Two notable parts of our 2021 report include the effect of COVID-19 and climate change on seasonal allergies. In 2020, fewer people felt the impact of pollen allergies. This is likely due to COVID-19 restrictions with more people staying indoors. But climate change continues to cause longer and more severe allergy seasons. If we don’t slow down the cycle, pollen production will only intensify. This means symptoms could worsen as climate change continues to evolve.”

Seasonal pollen allergies cause nasal, sinus, and other symptoms each spring through fall. Pollen can also trigger asthma attacks. Tree pollen season starts as early as January in some parts of the U.S. and continues through summer. In the fall, weed pollen including ragweed, causes symptoms. But relief is possible with the right treatment and by managing contact with pollen. Oklahoma City just had several allergy alert days in March for cedar and elm tree pollen which is always problematic in the winter months.

“It’s important people with seasonal allergies prepare. They should try their best to reduce exposure to pollen,” says Dr. Mitchell Grayson, chair of AAFA’s Medical Scientific Council and Director of the Division of Allergy and Immunology at Nationwide Children’s Hospital and The Ohio State University. “Schedule an appointment with your allergist to work on a treatment plan together to help reduce allergy symptoms when prevention is not enough.”

Treatment options include over-the-counter or prescription allergy medicines. Medications are most effective when started before allergy season begins.

“If medicines are not helping, it is important to establish care with an allergist to discuss what treatment options are best to reduce your allergy symptoms and attacks,” said Oklahoma Allergy & Asthma Board Certified Allergist (OAAC) Dr. Laura Chong.

The Allergy Capitals™ ranking is an annual research and educational project of AAFA, designed to help patients recognize, prevent and safely treat allergy symptoms. Through this ranking, AAFA raises awareness about the impact of seasonal allergies and provides helpful information designed to improve the quality of life for people who experience them. The ranking is based on local spring and fall pollen levels, use of allergy medication and the number of board-certified allergists in each metro area. Visit allergycapitals.com to see the full list, study methodology and learn more about allergy diagnosis, prevention and treatment.

To see the complete, 100-city list go to allergycapitals.com. The report lists overall annual rankings and breaks down a seasonal ranking for spring and fall.

The post Oklahoma City Ranks Ninth for Most Challenging Cities for Allergies appeared first on Oklahoma Allergy and Asthma Clinic.

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