Gastroesophageal reflux disease (GERD)

Gastroesophageal reflux refers to anything in the stomach that comes up into the food tube (esophagus). The most common and bothersome substance is stomach acid. The digestive enzyme pepsin is also produced in the stomach and may reflux or come up in to the esophagus and cause injury, symptoms, and illness.

Occasional reflux causes the well-known symptom of heartburn. Heartburn affects over 40% of the population at some time.

Some patients with gastroesophageal reflux disease do not present with heartburn but instead with symptoms of chest pain and/or chest pressure. This may mimic pain of cardiac origin.

Chronic irritation of the esophagus from reflux leads to gastroesophageal reflux disease.  Treatment is essential to avoid persistent symptoms and complications.

Laryngopharyngeal Reflux Disease (LPR, LPRD)

Laryngopharyngeal reflux is a variant of gastroesophageal reflux in which acid or pepsin comes all the way up into the throat. Just one episode of reflux every 24 to 48 hours can cause significant irritation and injury in many areas of the throat along with bothersome symptoms.

The majority of patients with laryngopharyngeal reflux disease do not have heartburn, but a host of other throat symptoms. Otolaryngologists (ear, nose and throat doctors) are the primary physicians involved in the diagnosis and treatment of this disorder.

Symptoms of Gastroesophageal Reflux Disease (GERD)

• Frequent or persistent heartburn
• Chest pain
• Chest pressure
• Dry cough
• Bad breath
• Nausea
• Repeated vomiting, especially in children

Symptoms of Laryngopharyngeal Reflux Disease (LPR, LPRD)

• Sensation of fullness or swelling in the throat
• Difficulty swallowing
• Dry cough
• Hoarseness
• Burning in the throat
• Sensation of postnasal drip
• Bitter taste

Causes

• Hiatal hernia, malfunctioning or abnormal lower esophageal sphincter muscle
• Abnormal contractions and or emptying of the esophagus or stomach
• Obesity
• Pregnancy
• Smoking
• Asthma
• Diabetes
• Poor diet
• alcohol intake

Diagnosis:

• Evaluation from an ear, nose, and throat specialist
• Evaluation from a gastroenterologist may be required

Treatment:

• Antacids
• Medications to reduce acid production in the stomach
• Changes in diet: avoidance of caffeine, alcohol, peppermint, chocolate, tomato, citrus juice or fruits, and weight loss
• Lifestyle changes such as timing of eating and laying down, elevation of the head of bed, discontinuing smoking