COPD and GERD
Laryngopharyngeal reflux (LPR) occurs when gastric contents pass the upper esophageal sphincter, causing symptoms such as hoarseness, sore throat, coughing, excess throat mucus, and globus. The pattern of reflux is different in LPR and gastroesophageal reflux. LPR usually occurs during the daytime in the upright position whereas gastroesophageal reflux disease more often occurs in the supine position at night-time or during sleep. Ambulatory 24-h double pH-probe monitoring is the gold standard diagnostic tool for LPR. Acid suppression with proton pump inhibitor on a long-term basis is the mainstay of treatment.
Although PPIs effectively reduce the acid secretion, reflux still continues, meaning that the larynx and pharynx are still exposed to pepsin and bile. In some people, stomach contents regularly leak into their food pipe, or a relatively large amount leaks out. It is considered to be GERD if this causes frequent or severe heartburn or acid reflux that affects your quality of life, or if your food pipe has become inflamed.
The trouble-free periods become longer to be completely eliminated over time by naturally treating the cause behind your reflux. Reflux is caused by the opening in the diaphragm, where the oesophagus passes through, becoming weakened, so the upper part of the stomach slides freely up and down through the gap. When the stomach is able to freely slide up into the chest cavity, the lower oesophageal sphincter loses the ability to stay tight, which allows corrosive acid to leak up into the oesophagus.
People with acid reflux may have what is called “micro-“aspiration and not know about it, especially as a cause of nighttime coughing and wheezing. If untreated, chronic aspiration can damage the lungs by causing inflammation, infection and scarring.
So, my plea to you is to take a good voice history, listen to the patient, look for habituation, develop a relationship with a speech-therapy rehabilitation clinician or a laryngologist who has a vested interest in voice. These patients will need speech rehabilitation, and the habits will go away with time. Prescribe PPI therapy if you are going to study these patients. You don’t want to study them and find that they have reflux, and then they say, “Now what do we do?” I study them on therapy and look for events that I can mark as a symptom event.
When GER becomes GERD
Avoid highly acidic or spicy foods and beverages such as citrus fruits and juices, tomatoes, salad dressings, and barbecue or hot sauces. These foods irritate the tissues lining the throat and voice box. Avoid caffeine, alcohol, chocolate, and peppermint, which weaken both esophageal sphincters. Even decaffeinated teas and coffees contain enough caffeine to cause trouble.
Acid controlling medications donâ€™t treat the cause of acid reflux, they just reduce stomach acid. The only way to stop acid reflux completely is to correct the weakness in the LES with reflux surgery. If youâ€™re interested in learning more about how surgery can solve your acid reflux, contact Dr. Malladi today.
Dietary factors often contribute to acid reflux. Certain foods are acids or irritants themselves; others will bring out stomach acid in large amounts. Both should be avoided. There is also a small chance of developing cancer in the esophagus or throat due to long-term acid reflux. The following information is intended to help you understand acid reflux and the steps you may take to reduce this problem.
Heartburn and GERD: Overview
19. Koufman JA, Amin MR, Panetti M. Prevalence of reflux in 113 consecutive patients with laryngeal and voice disorders. Endoscopic examination of the esophagus (transnasal esophagoscopy; TNE) is performed in the clinical setting with or without sedation. It is generally used to check GERD-related complications and exclude other diseases. TNE allows otolaryngologists to screen the esophagus.
Along with the accumulation of mucus can come other throat symptoms such as hoarseness, throat clearing and chronic cough, sore throat, sensation of having something stuck in the throat and trouble swallowing. Acid reflux can also cause a post-nasal drip, which may be related to sinusitis or inflammation of the sinuses.
It is minimally invasive and connects the upper part of the stomach to the esophagus. This will reduce reflux. Most patients return to their normal activities in a couple of weeks, after a brief, one to three day hospital stay.