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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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Ragweed Season is HERE

Ragweed Season

Ragweed Plants Packed with Pollen

Summer fun can turn to fall misery for millions of people who suffer from seasonal allergic rhinitis (hay fever). Sneezing, stuffy or runny nose, itchy eyes, nose and throat, or worsening of asthma symptoms are common in people with undiagnosed or poorly managed hay fever.

The primary culprit of fall allergies is ragweed pollen. A ragweed plant only lives one season, but it packs a powerful punch. A single plant can produce up to 1 billion pollen grains. These grains are very light weight and float easily through the air.

Fall allergy symptoms used to start in mid-August and run through September. In many parts of the country these symptoms now begin in early August and extend through October. Some studies suggest that rising temperatures and higher carbon dioxide levels contribute to longer growth time of allergen-producing plants. In 2023, OAAC reported high ragweed counts beginning in the third week of August. In fact, on August 28, 2023, we had our first ragweed allergy alert day.

Allergies occur when the body’s immune system treats the allergen, in this case ragweed, as a foreign invader. This starts a chemical reaction which produces and sends histamine throughout the blood stream. These chemicals cause allergy symptoms to develop.

Controlling symptoms
Proper diagnosis is the first step in managing your symptoms. An allergist will give a physical exam, ask about your health history and perform allergy testing to determine exactly what you are and are not allergic to.

Although there is no cure, ragweed allergy can be managed to improve the quality of your life.

The best control is to avoid contact with the pollen. This can be difficult, but resources are available. The National Allergy BureauTM (NAB) tracks pollen counts regionally to help you plan when you should avoid spending a lot of time outdoors. Remember to follow the OAAC on social media for the OKC area. Our counts are collected from the top of our main office building Monday-Friday by our certified pollen counters.

Talk to your doctor about medications that may provide temporary relief from symptoms. Your allergist/immunologist may also recommend immunotherapy (allergy shots) or sublingual immunotherapy (SLIT) allergy tablets, treatment. This long-term treatment approach can significantly reduce the frequency and severity of symptoms caused by allergic rhinitis.

Did you know?

  • The tall goldenrod species of ragweed gets blamed for most of the pollen, but a primary cause of allergy symptoms is the tooth-leaved ragweed that lives low in the grass.
    • Ragweed can be found in almost all states in the United States as well as in Canada.
    • An accurate diagnosis is essential for managing symptoms. Allergy testing performed by an allergist can determine what you are and not allergic to.To the point
    Although often associated with hay fever, ragweed can also cause skin conditions such as allergic contact dermatitis and hives.

Source: AAAAI.org

The post Ragweed Season is HERE appeared first on Oklahoma Allergy and Asthma Clinic.

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