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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

Why Should You Visit an Allergist
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Why Should You Visit an Allergist

Is it a cold, the flu, or persistent seasonal allergies made worse by Oklahoma weather? Do your rashes seem to appear at a certain time of year or after you eat specific foods? A board-certified allergist can help you untangle these mysteries and get you to a place where you feel. In this article, you will learn the following points:

  • What an allergist does and what they test for
  • When you may consider getting an allergy test

When You Go to an Allergist, What Do They Do?

Allergists perform testing to determine what their patients are allergic to. They prescribe various treatments, including antihistamines, inhalers, creams, and allergen immunotherapy, to help their patients feel better. If you're considering visiting an allergist, think about your symptoms and when they appear. For example, you may know that you have a severe cat allergy if you always sneeze, cough, or break out into hives when you visit your best friend, who has five feline companions in the house. A food allergy may be equally obvious and even life-threatening due to its severity.

On the other hand, you may have no clue what you're allergic to. This is where a qualified allergist can help you by performing standardized, research-backed allergy testing to determine the cause of your suffering.

What Do Allergists Usually Test For?

Your allergist at Oklahoma Allergy & Asthma Clinic will first talk to you, discuss your medical history and review your symptoms. If you experience hives or anaphylactic shock (a serious, life-threatening reaction) after eating a food, your doctor may run a series of tests to determine the offending food. If your symptoms involve itchy eyes, sneezing, a sore throat, or a cough, your allergist will likely perform a skin test for environmental allergies such as different types of pollen, animal dander, dust, and mold.

If you have eczema or other skin symptoms related to allergies, the allergist may review the products you use daily and perform patch testing for contact dermatitis caused by lotions, shampoos, or fragrances.

When Should You Get an Allergy Test?

When to see an allergist depends on the severity and frequency of your symptoms. Sometimes, it's enough for patients with milder symptoms to simply take an over-the-counter antihistamine for the duration of allergy season. If your symptoms are frequent and bothersome, you've had a severe reaction to food, or you have symptoms of asthma, including shortness of breath or frequent coughing, it's time to visit an allergist for treatment. Allergies typically don't get better over time, but a personalized treatment regimen can help a great deal.

Is It Expensive To See an Allergist?

Your insurance may cover part or all your consultation and testing. Don't let financial concerns stop you from seeing an allergist — especially if you or your child is suffering from chronic or unexplainable symptoms. Treating allergies can drastically improve a person's quality of life.

Get in touch with Oklahoma Allergy & Asthma Clinic as soon as possible to determine coverage for evaluation of services. We look forward to serving you and your family!

Image Source: ronstik / Shutterstock

The post Why Should You Visit an Allergist appeared first on Oklahoma Allergy and Asthma Clinic.

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