What This Means For You
Although more research is required to reach a conclusive diagnosis, there is enough scientific proof from clinical trials and studies that show treating GERD directly may also improve ear and nose symptoms.
As a GERD patient experiencing ear and sinus complications, we recommend visiting an ENT and informing him or her regarding your chronic reflux condition. With this information, you can have peace of mind knowing that there are medical therapies available to improve your discomfort.
What Are The Symptoms Of Acid Reflux And Gerd
Both acid reflux and GERD share many of the same symptoms, including:
- Burning sensation in the chest and throat
- Belching or hiccuping frequently after eating
- Sore throat or throat irritation
- Trouble swallowing
- Foul taste in mouth or back of the throat
If you have gastroesophageal reflux disease, there may be a few additional symptoms, such as:
- Bad breath
- Severe chest pain sometimes mistaken for a heart attack
How Common Is Gerd
GERD is very common. The condition and its symptoms touch a huge number of people: 20% of the U.S. population.
Anyone of any age can develop GERD, but some may be more at risk for it. For example, the chances youll have some form of GERD increase after age 40.
Youre also more likely to have it if youre:
- Overweight or obese.
- Smoking or are regularly exposed to second-hand smoke.
- Taking certain medications that may cause acid reflux.
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How Is Laryngopharyngeal Reflux Diagnosed
LPR is usually diagnosed based on the patients symptoms of irritation or swelling in the throat and the back of the voice box. In many cases, no testing is needed to make the diagnosis.
If testing is needed, three commonly used tests are: a swallowing study a direct look at the stomach and esophagus through an endoscope, and an esophageal pH test:
- In a swallowing study, the patient swallows a special liquid called barium, which coats the esophagus, stomach and intestine so they are outlined on an X-ray. This allows the doctor to see the movement of food as it passes from the mouth to the esophagus.
- The doctor can also view the inside of the stomach and esophagus with an endoscope, a long thin tube with a camera on the end that the doctor passes through the mouth, down the esophagus and into the stomach.
- The esophageal pH test measures and records the pH in the esophagus. A thin, small tube with a device on the tip that senses acid is gently passed through the nose, down the esophagus, and positioned about 2 inches above the lower esophageal sphincter. The tube is fastened to the side of the face with tape. The end of the tube that comes out of the nose is attached to a portable recorder that is worn on the belt or over the shoulder. The recorder has several buttons on it that the patient presses to mark certain events.
What Are The Main Symptoms Of Gerd
The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning or trouble swallowing. You may feel like you have food stuck in your throat, or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.
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Behavioral And Other Factors
As mentioned above, body weight is a significant factor in promoting reflux of stomach acid, and weight reduction is helpful.
Pregnancy will markedly increase symptoms of heartburn and sometimes throat symptoms as well. This is partly due to the space taken up by the growing infant. One should avoid clothing that fits tightly across the midsection of the body. It is helpful to practice abdominal or diaphragmatic breathing. This means you should concentrate on pushing out the stomach with each breath instead of expanding the chest. Avoid slumping when sitting down. Avoid bending or stooping as much as you can.
For many people, reflux occurs most often at night and sets up the irritation that continues to bother during the daytime. One of the most important things you can do is to elevate the head of your bed. To do this, use blocks, books or bricks underneath the legs at the head of the bed. The elevation should be 4-6 inches or so, but not high enough that you will slide down when sleeping. Professional singers with acid reflux should consider traveling with blocks in their suitcase for use in hotel rooms.
The use of multiple pillows to get the head up is not effective because it causes the body to curl unless the pillows are maintained under the shoulders in addition to the head. Wedge-shaped pillows can be helpful in this regard.
Acid Reflux And Sinusitis Connection:
Acid reflux laryngopharyngeal reflux and sinusitis, do indeed overlap. Sometimes, the symptoms of GERD can mimic some of the symptoms of sinusitis. The acid reflux causing post nasal drip problems. As a result, sinus infection sticking in the back of the throat. Sinusitis causes all the other symptoms like sinus discharge, headache, congestion, cough, and sore throat!
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Tell Me About Surgical Treatment Of Gerd
Surgical treatment is undertaken as a last resort. If the dietary and medical treatments do not bring relief, or if the patient finds them hard to comply with, they may be candidates for surgery. One procedure is called fundoplication. It involves wrapping the top of the stomach around the top of the esophagus in order to strengthen support and prevent reflux. If possible, it is preferable to control GERD with medical treatment!
Sinusitis occurs when viruses or bacteria infect the sinus cavities, usually due to blockage of the small drainage pathways that lead to the nasal passages. This causes an inflammation of the sinuses, which stops proper drainage. Symptoms include facial pain, headaches, nasal drainage, cough, postnasal drip, bad breath, upper jaw pain, sore throat, sensitive eyes, swelling of the eyelids, general fatigue, and fever. Even after treatment of a sinus infection, inflammation can persist. Chronic sinusitis refers to inflammation of the sinuses that continues for at least a few weeks, but often continues for months or even years.
Can Postnasal Drip Cause Gerd
Its unlikely for postnasal drip to cause GERD. As mentioned above, GERD is primarily a problem with the muscles that separate your esophagus from your stomach. But many things can increase the irritation in your esophagus or trigger the overproduction of stomach acids.
Mucus from postnasal drip is just one of the many fluids that pass through the esophagus each day. Mucus production triggered by viral illnesses or other infections can irritate the lining of the throat, making it more sensitive to damage from stomach acids. You may also develop a cough with postnasal drip that could further irritate the tissue in your esophagus.
So, although postnasal drip probably wont cause GERD, it can still leave you with an uncomfortable feeling in your esophagus.
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Study Design And Participants
In this retrospective cohort study, we enrolled a cohort of 15,807 adult subjects who were newly diagnosed as having GERD and who subsequently received proton pump inhibitor for treatment of that disease between January 1, 2007 and December 31, 2009 from the LHID 2010. The date on which the diagnosis of GERD was recorded in the Registry was defined as the index date. This diagnosis was validated by the prescription of PPI because Taiwan’s Bureau of NHI only reimburses PPI for patients with GERD confirmed by panendoscopy or 24-hour pH-meter monitoring. We created a control group of 47,421 patients without GERD from the remaining beneficiaries of LHID 2010. We used propensity score matching to match patients and controls by sex, age strata , index year, and comorbidity types. The selected comorbidities for which the subjects were matched are recognized to be common premorbid illness of CRS,14,15 including asthma , allergic rhinitis , otitis media , adenotonsillitis , atopic dermatitis , and pneumonia . In both groups, subjects with a prior diagnosis of GERD, CRS , human immunodeficiency virus infection , or primary immune deficiency before the index date were excluded. Ultimately, 63,228 subjects were enrolled. The flowchart for the selection process is shown in Figure Figure11.
Flow chart of selection of GERD patients and matched controls from the NHIRD in Taiwan. CRS=chronic rhinosinusitis, GERD=gastroesophageal reflux disease, ICD=International Classification of Diseases.
How To Know If Its Acid Reflux Or Asthma
Some people who may be suffering from breathing problems may have difficulty understanding if their problem is related to acid reflux or instead asthma luckily, there is a reliable way to know the difference.
Someone who has asthma will have difficulty exhaling whereas someone who is being affected by acid reflux will have trouble inhaling . This is the clear distinction between the 2 that is important to know.
Its also worth mentioning that there is a relation between acid reflux and sinusitis. If you didnt know sinusitis is a problem where the lining of the sinuses become inflamed.
One of the more common causes is due to viral infections but in our case the pepsin is causing the damage and inflammation. The same thing can also be said for postnasal drip and acid reflux. Its a cause that sometimes isnt even considered.
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Check If You Have Acid Reflux
The main symptoms of acid reflux are:
- heartburn a burning sensation in the middle of your chest
- an unpleasant sour taste in your mouth, caused by stomach acid
You may also have:
- a cough or hiccups that keep coming back
- a hoarse voice
Your symptoms will probably be worse after eating, when lying down and when bending over.
Are Heartburn And Acid Reflux Impacting Your Life
The heart has nothing to do with heartburn. Heartburn is mild to severe pain caused by digestive issues. While this issue is quite common and experienced by millions of Americans, that doesnt change how uncomfortable it is. Do you feel a sharp burning sensation behind your breastbone that moves upwards toward your neck and throat after eating? Does bending over or lying down only make you feel worse?
Heartburn is the main symptom of acid reflux and its chronic and more severe counterpart gastroesophageal reflux disease . Finding out what is causing your heartburn could be your first step toward relief. At Houston Sinus & Allergy, you can meet acid reflux and GERD doctors in Houston who can help you find treatment that works.
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What Medications Do I Take To Manage The Symptoms Of Gerd
Many over-the-counter and prescription medications relieve GERD. Most of OTC drugs come in prescription strength too. Your provider will give you a prescription for these stronger drugs if youre not getting relief from the OTC formulas.
The most common GERD medications:
- Antacids include Tums®, Rolaids®, Mylanta®, Riopan® and Maalox®.
- H-2 receptor blockers include Tagamet®, Pepcid AC®, Axid AR® and Zantac®.
- Proton pump inhibitors include Prevacid®, Prilosec®, Zegerid®, Nexium®, Protonix®, AcipHex® and Dexilant®.
- Baclofen is a prescription drug used to reduce the relaxation of the lower esophageal sphincter which allows acid backwash.
Can Acid Reflux Cause Sinus Pain
Sinus pain isnt the first thing that comes to mind for most people when they think of acid reflux. But in addition to heartburn and other digestive complaints, acid reflux can play a role in a number of respiratory ailments, including asthma, post nasal drip and chronic cough. Whether acid reflux — also known as gastroesophageal reflux disease, or GERD — can affect the sinuses is a matter of increasing interest to researchers. While a medical consensus hasnt quite been reached, a number of studies make a very plausible connection between GERD and chronic sinusitis.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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Are There Any Diagnostic Tests
A gastroenterologist may decide to order some additional tests to evaluate your GERD. A Barium swallow is a series of x-ray films that monitor dye as it travels through the stomach. A PH monitoring test is a 24-hour test to record the back flow of acid from the stomach into the esophagus and even the throat. A small flexible tube is placed in the stomach through the nose and is connected to a small computer to record 24-hour acid reflux. Endoscopy is sometimes performed to evaluate the esophagus for damage from acid burns and to examine the stomach for irritation and ulceration.
Laryngopharyngeal Reflux Or Lpr Is One Of The Most Missed Medical Conditions Yet It Can Cause So Many Symptoms Including Nasal Congestion Or Sinusitis
First off, just because acid from the stomach can reflux high enough to contact the throat and even affect the nasal passages, doesnt mean that the patient will necessarily feel heartburn or chest pain.
When the acid shoots up the esophagus to throat or nasal level, it may not remain long enough in the esophagus to cause the classic burning sensation in the chest.
Thus, you should never assume that you cant possibly have LPR just because you never have heartburn or stomach discomfort.
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Where Are The Esophageal Sphincter Muscles
The upper esophageal sphincter keeps stomach acid out of the pharynx and larynx. When it doesn’t work properly, you can develop symptoms such as hoarseness, loss of voice, chronic cough, phlegm in the back of the throat, and a feeling that something is stuck in the throat. Although the stomach contents come in contact with the lower esophagus before reaching the throat, only about 35% of people with LPR also experience GERD. Experts don’t know why. It may be that the larynx and pharynx are more sensitive to acid than the esophagus. Also, refluxed acid is more likely to pool in the larynx and pharynx, resulting in prolonged exposure. GERD symptoms are usually worst when you are lying down, while LPR often occurs when you are standing or bending over or exercising.
LPR is usually diagnosed by symptoms, although a specialist may look directly at the area with a laryngoscope for signs of swelling and inflammation. The treatment of LPR begins with changes in diet and behavior, including these:
If diet and behavior changes don’t help, a medication may be prescribed usually, treatment starts with a proton-pump inhibitor . Commonly prescribed PPIs include rabeprazole , esomeprazole , lansoprazole , omeprazole , and pantoprazole . They all work by reducing the amount of acid made in the stomach.
Celeste Robb-Nicholson, M.D.
Treating Gerd Eases Sinus Problems And Doctors Are Starting To Find Out Why
THURSDAY, May 27, 2004 — Specialists treating acid reflux disease or chronic sinusitis have long noticed the two ailments tend to go hand-in-hand.
Now, scientists believe they are reaching a better understanding of the link between troubled stomachs and stuffy noses.
Acid reflux disease “is probably not the cause of sinusitis, but it may be participating in some cases,” said Dr. Timothy Smith, a professor of otolaryngology and chief of rhinology and sinus surgery at the Medical College of Wisconsin in Milwaukee.
Sinus specialists see the two conditions “intersecting fairly consistently in clinical practice,” he added.
Millions of Americans suffer from heartburn and discomfort linked to gastroesophageal reflux disease , a condition characterized by frequent entry into the esophagus of harsh stomach acids. Besides being uncomfortable, GERD raises risks for more serious conditions, such as esophagitis, Barrett’s esophagus and even esophageal cancer.
An estimated 34 million Americans also suffer from chronic sinusitis, which is characterized by inflammation of the nasal passages. The inflammation shrinks the passages so mucus can’t drain properly, causing the discomfort and infection that are hallmarks of sinusitis.
And a large proportion of sinus patients are also affected by acid reflux. However, connections between the two ailments have remained unclear.
More information
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How Reflux Leads To Coughing
Of course, in some cases, chronic cough may be caused or made worse by acid reflux. There are two possible mechanisms to explain this occurrence.
The first suggests that a cough occurs as a reflexive action set off by the rising of stomach acid into the food pipe.
The second mechanism proposes that reflux moves above the food pipe and causes tiny droplets of stomach acid to land in the voice box or throat. This type of reflux is known as laryngeal pharyngeal reflux . LPR may lead to the development of a cough as a protective mechanism against the reflux.
Treatment Of Nasal Polyps
There is good news for patients with sinus polyps. In the past, the only option we had was surgical treatment which involved just removing the polyps and hoping they didn’t come back this was historically very ineffective and patients had frequent recurrences of their polyps. Now, due to technologies such as Propel, patients undergoing polyp surgery can have small absorbable devices placed in their sinus cavities that dissolve during the month following the surgery. These small devices contain steroids which dissolve into the sinus passages and help cut down on the recurrence.
The other advantage of these devices is that they have a spring type effect that keeps the sinuses open. That’s very important for post-operative care, because many patients need to use nasal steroids and saline rinses after their polyps are removed, but their sinuses often close down making the rinses ineffective. By keeping the sinuses open, thus allowing the medicines to get into the root of the sinuses, the results have improved dramatically for patients suffering from sinus polyps.
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