Reflux

Gastroesophageal Reflux (GERD)

Gastroesophageal reflux disease, also known as GERD, takes place when the lower esophageal sphincter (LES) does not work adequately, allowing stomach acid to enter into the esophagus in significant amounts. This results in the sensation of “heartburn.” Normally, the LES constricts to prevent contents in the stomach from refluxing into the esophagus. Most people experience heartburn from time to time, but if it starts occurring more than twice a week, you may have Gastroesophageal reflux disease.

  • Symptoms Of GERD
  • Persistent or frequent heartburn
  • Acid regurgitation into the throat with sour taste and nausea
  • Pain in the chest that mimics a heart attack
  • Hoarseness, especially in the morning
  • Trouble swallowing
  • The sensation of having food or phlegm stuck in the throat
  • Dry, irritative cough
  • Bad breath

Laryngopharyngeal Reflux (LPR)

Laryngopharyngeal reflux (LPR) is similar to GERD but has several notable differences. Many patients with LPR do not experience heartburn because the volume and frequency of refluxing are not high. However, patients with LPR have the acidic stomach contents continue past the upper esophageal sphincter and into the back of the throat. While the esophagus is a hearty, muscular organ designed to handle some reflux as well as spicy food and even caustic substances such as alcohol on occasion, the larynx or voice box, in contrast, is a delicate organ that is severely irritated by even a small amount of the digestive enzymes in the gastric contents. This invariably causes swelling of the soft tissues, which to the patient feels like phlegm in the throat that they just cannot clear.

Symptoms Of LPR In Adults

  • Frequent nonproductive throat clearing
  • Feeling that something is stuck in the throat
  • A bitter taste
  • A sensation of burning or soreness, often worse on one side of the throat
  • Hoarseness
  • Difficulty swallowing

Symptoms Of LPR In Infants And Children

  • Cough
  • Hoarseness
  • Stridor (noisy breathing)
  • Croup
  • Asthma
  • Sleep-disordered breathing
  • Feeding difficulty (spitting up)
  • Turning blue (cyanosis)
  • Aspiration
  • Sleep apnea
  • Severe deficiency in growth

Causes Of GERD And LPR

Alcohol use, obesity, pregnancy, over-eating, anatomical abnormalities, and smoking can all make it more likely for a person to have gastroesophageal reflux disease and laryngopharyngeal reflux disease. Certain foods can also trigger the conditions, such as dairy products, chocolate, spicy foods, caffeinated recreational beverages, and tomato-based foods.

Early Detection & Treatment Is Important

If left untreated, GERD and LPR can result in more serious medical problems, including ulcers, precipitated asthma attacks in asthmatics, throat and laryngeal inflammation, secondary inflammation, and infection of the lungs, and even collection of fluid in the sinuses and middle ear in rare cases. GERD can also cause Barrett’s Esophagus, a condition that along with LPR has been found to lead to cancer in some patients.

The ENT physicians at CornerStone Ear, Nose & Throat have the expertise to diagnose GERD and LPR. If appropriate, a videostroboscopy may be recommended to obtain a more precise and baseline diagnosis. Patients with predominantly GERD symptoms are more typically referred to a gastroenterologist for ongoing diagnosis and treatment.