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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 Asthma
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Oklahoma City Ranks Ninth for Most Challenging Cities for Asthma

AAFA’s 2021 Asthma Capitals™ Report Lists Most Challenging Cities to Live in the U.S. with Asthma; Oklahoma City takes ninth place for 2021

The Asthma and Allergy Foundation of America (AAFA) recently rolled out its 2021 Asthma Capitals™ report. The report coincided with World Asthma Day, part of National Asthma and Allergy Awareness Month. AAFA’s Asthma Capitals™ report analyzes data from the 100 largest cities in the United States to determine its ranking. Allentown, Pennsylvania takes the top spot as the most challenging place to live for asthma in the 2021 report. Oklahoma City was ranked ninth and Tulsa was 24th.

The ranking is based on three criteria: asthma prevalence, emergency department visits for asthma, and deaths due to asthma. The report also highlights risk factors including poverty, air pollution, access to specialists, pollen counts, medicine use, smoking policies, and the rate of uninsured residents in an area. AAFA previously identified existing “Asthma Belts” which continue to have a grip on the eastern half of the nation, however two western cities – Tucson, Arizona and Fresno, California, are also listed in the top 20 cities for this year’s report. The top 20 Asthma Capitals™ for 2021 are: 1. Allentown, Pennsylvania 2. Baltimore, Maryland 3. Richmond, Virginia 4. Milwaukee, Wisconsin 5. New Haven, Connecticut 6. Cleveland, Ohio 7. Philadelphia, Pennsylvania 8. Dayton, Ohio 9. Oklahoma City, Oklahoma 10. Tucson, Arizona 11. Worcester, Massachusetts 12. Springfield, Massachusetts 13. Columbus, Ohio 14. Birmingham, Alabama 15. Detroit, Michigan 16. Louisville, Kentucky 17. Hartford, Connecticut 18. Boston, Massachusetts 19. Fresno, California 20. Greensboro, North Carolina. To see the complete 100-city list, visit asthmacapitals.com.

“AAFA produces the Asthma Capitals report and similar research to help improve the lives of the estimated 25 million Americans living with asthma. It’s important to highlight areas which deserve our urgent attention and collective action. This includes the pressing need to develop more programs and policies that will effectively help us reduce stark disparities in asthma based on race, gender, income and where people live,” said Kenneth Mendez, CEO and president of AAFA. “This report also supports the need for climate action. Air pollution, extreme weather patterns, and natural disasters fueled by climate change continue to have a worsening impact on Americans living in certain communities. This is not only a critical area of investigation, but signals exactly where work needs to be done for those with the greatest needs.”

The report also calls attention to the role of the COVID-19 pandemic in determining the rankings. This includes some changes in health outcomes and risk factors like pollen exposure, medicine use, and emergency room visits. In 2020, fewer people experienced pollen allergies due to COVID-19 restrictions, recommendations to stay indoors, and other preventative measures like mask wearing. As a result, use of long-term asthma medicines were also down along with fewer people heading to hospital emergency rooms for asthma.

“The pandemic, economic recession, climate crisis, and racial injustice all had a significant impact on the asthma community in 2020. Despite some varying factors, asthma remains a serious public health threat with an average of 10 people dying each day. At AAFA, we reiterate that’s 10 too many. Most of these tragedies are preventable,” said Melanie Carver, chief mission officer at AAFA. “Stakeholders, policy makers, health officials, communities and individuals around the nation can use this information to join us in our mission to save lives.”

“It’s been an especially challenging year for allergies so far with high pollen and mold spore counts along with high allergy alert days,” said Oklahoma Allergy & Asthma Clinic Board-certified allergist Dr. Laura Chong. “All of these can be triggers for increases in asthma attacks too. It is important to get an evaluation to figure out your triggers and the best strategy to help optimize control of your asthma.”

The 2021 Asthma Capitals™ report is an independent research project of AAFA made possible in part by support from the Pharmaceutical Care Management Association (PCMA) Foundation. For the latest AAFA news and resources go to aafa.org.

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

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