Acid reflux, or gastroesophageal reflux disease (GERD), is a chronic digestive condition that causes painful heartburn and regurgitation for millions of Americans every year. It occurs when the contents of the stomach seep backward into the esophagus.
What Causes Reflux?
Normally, following a meal, a valve on your esophagus – the sphincter – closes, preventing hydrochloric acid produced in the digestive process from backing up (refluxing) into the esophagus. When reflux occurs, this valve fails to seal properly, and the stomach contents flow freely into the throat and esophagus. This damages the esophageal lining and causes a variety of painful symptoms.
Other risk factors can help to exacerbate the condition. These include eating large meals or lying down afterward, eating certain foods (spicy and fatty foods, citrus, tomato, chocolate, mint, garlic and onions), drinking certain beverages (alcohol, caffeine, carbonated liquids), smoking, obesity and pregnancy.
What Are the Symptoms of GERD?
Heartburn is most commonly associated with GERD. Also known as acid indigestion, this burning pain radiates from the stomach to the abdomen and chest and may last for up to two hours after a meal. It is frequently accompanied by regurgitation, a sour taste in the mouth, and dyspepsia or general stomach discomfort. Other symptoms often include belching, bloating, coughing, wheezing, hoarseness and nausea.
Symptoms occur most frequently after eating, when lying down or when bending over. They are most common at night. The most common cause of GERD is a hiatal hernia, a stomach abnormality that causes the sphincter valve and upper portion of the stomach to move above the diaphragm, allowing stomach acids to reflux more easily.
How Is Reflux Treated?
An effective way to treat acid reflux is to avoid the triggers that cause painful heartburn and other symptoms. Stay away from those foods and beverages that are likely to cause a negative reaction. Change your eating habits: stick with smaller, more frequent meals, and avoid eating too closely to bedtime. Quit smoking and ask your doctor if the medications you are taking might be responsible for your symptoms. If you are overweight, exercise to take off excess pounds.
Over-the-counter antacids taken immediately after meals will help neutralize stomach acids and can prevent heartburn from occurring or relieve the symptoms. For serious cases that do not respond to medical treatment, surgery may be recommended.
What About Laryngopharyngeal Reflux?
Laryngopharyngeal reflux (LPR), also known as silent reflux or extraesophageal reflux, is a condition where stomach acid and digestive enzymes flow back into the larynx (voice box), pharynx (throat), and sometimes the nasal passages. Unlike gastroesophageal reflux disease (GERD), which primarily affects the lower esophagus, LPR primarily affects the upper airway and can cause a variety of symptoms.
Symptoms of LPR
- Hoarseness: Often the most common symptom due to irritation of the vocal cords.
- Throat clearing: Constant need to clear the throat.
- Chronic cough: Persistent dry or wet cough that doesn’t seem to go away.
- Sore throat: A feeling of irritation or soreness in the throat.
- Difficulty swallowing: Known as dysphagia, which can occur due to swelling or narrowing of the throat.
- Postnasal drip: Excess mucus production leading to a sensation of mucus at the back of the throat.
- Asthma-like symptoms: Wheezing or difficulty breathing, especially at night.
Causes and Risk Factors for LPR
- Weakened lower esophageal sphincter (LES): The LES normally prevents stomach acid from flowing back into the esophagus and beyond. When weakened, acid can reach higher into the throat.
- Hiatal hernia: A condition where a portion of the stomach pushes up through the diaphragm into the chest cavity, increasing the likelihood of reflux.
- Diet and lifestyle: Factors such as consuming acidic or spicy foods, smoking, excessive alcohol intake, and obesity can contribute to LPR.
- Anatomical abnormalities: Some individuals may have structural abnormalities that predispose them to reflux.
Diagnosis and Treatment of LPR
- Diagnosis: Often involves a combination of symptoms assessment, physical examination, and sometimes diagnostic tests such as pH monitoring, laryngoscopy or imaging studies to assess the extent of damage, especially if accompanied by difficulty swallowing.
- Treatment: Includes lifestyle modifications (e.g., dietary changes, weight loss), medications to reduce acid production or protect the esophagus, and in severe cases, surgery to strengthen the LES or correct anatomical issues.
Complications of LPR
If left untreated, LPR can lead to more serious complications such as vocal cord nodules or ulcers, chronic laryngitis, Barrett’s esophagus (a precancerous condition) or worsening asthma symptoms in susceptible individuals.
Overall, early recognition and management of LPR are crucial to prevent complications and improve quality of life, especially in individuals with persistent throat symptoms that do not respond to typical treatments for other conditions like allergies or respiratory infections.
Call Carolina Ear Nose & Throat – Sinus and Allergy Center at (828) 322-2183 for more information or to schedule an appointment.