This a very common and under diagnosed condition that is also know as GERD (gastro-esophageal reflux disease), LPR (laryngo-pharyngeal reflux), Silent Acid Reflux and Heartburn. This condition can occur acutely, chronically or in recurrent episodes and can affect all age groups from infants to the elderly. It occurs when stomach acid or pepsin refluxes up into the throat, nose, sinus and inner ear causing inflammation, irritation and swelling of these structures.
SYMPTOMS: Very often acid reflux can mimic a cold, sinus infection, tonsillitis or bronchitis. Symptoms include throat irritation, scratchy throat, sore throat, low grade fever, fatigue, poor sleep, frequent throat clearing, feeling of swelling or lump in throat, mucous in throat, dry and spastic cough, hoarseness, post nasal drip, nasal congestion, sinus congestion, ear pressure and popping, bad breath, tongue irritation, dental problems and gum inflammation. A patent may or may not have associated heartburn or stomach symptoms. In fact, most patients have no stomach or heartburn symptoms at all – this is Silent Acid Reflux.
CAUSES: Over production of stomach acid, delayed emptying of acid from the stomach, weak lower esophagus sphincter, gastritis, medications, stress, alcohol, fatty and fried foods, acid foods and beverage, being overweight, sleep apnea / snoring, anxiety, exercise, overeating and congenital/ hereditary factors.
DIAGNOSIS: Acid reflux is diagnosed by a review of medical history and a physical exam. A key part of the exam is to look directly at a patient’s throat and voice box by performing a Flexible Laryngoscopy in the office. In addition, an esophagram (a x-ray of the throat and stomach) can be very useful. Often consultation with a Gastroenterologist (GI doctor) can help provide long term benefit and resolution of symptoms.
TREATMENT: Lifestyle and dietary modification are the cornerstones of the treatment the acid reflux. Short term use of medications can be used and very often help “kick start” the process so that non-medicinal approaches can be used for the long run. Natural remedies are also very helpful when used properly and consistently. Stress management can have immediate impact on acid reflux. Acupuncture has also shown to help with the chronic inflammation of acid reflux. In more severe cases or where patients just aren’t getting better a consultation with a Gastroenterologist (GI doctor) is done.