Gastroesophageal Reflux Disease or GERD

Gastroesophageal reflux disease or GERD is a chronic disease and usually is life-long once it begins. This is a condition in which the liquid of the stomach regurgitates backs up into the esophagus. The regurgitated liquid contains acid and pepsin (pepsin is an enzyme that begins the digestion of the proteins in the stomach) which is produced by the stomach.

GERD affects at least 5-7% of the global population in men, women and children. Although common, GERD is often unrecognized and misunderstood. This can be unfortunate since GERD is generally a treatable disease.

It is important for individuals who suffer persistent heartburn or other chronic and recurrent symptoms of GERD to seek an accurate diagnosis. Working with a physician is the first step to receiving the most effective treatments.

Adult symptoms of GERD:

  • Frequent heartburn
  • Asthma
  • Sore throat
  • Nausea
  • Hoarseness
  • Laryngitis
  • Feeling as if there is a lump in your throat
  • Earaches
  • Bad breath

Symptoms in infants and Children:

  • Recurrent vomiting
  • Breathing problems
  • Failure to thrive
  • Coughing

This is an Endoscopic view of the narrowing of the esophagus near the area joining with the stomach.

Treatments for Gerd:

To manage GERD you must reduce the amount of acid in your stomach and the amount of reflux that occurs. If you have a mild case, this can be treated by using over-the-counter antacids and making certain lifestyle changes. Sometimes lifestyle changes and medications may not be sufficient to control even mild cases. For uncontrollable cases, GERD is first treated with prescription medications and then sometimes with surgery.

Some types of drugs generally used for the treatment are H2 blockers such as Pepcid, Axid, Zantac, and Tagamet. These can help decrease the stomach’s production of acid and work best for some people with mild GERD. For moderate or severe cases physicians may use medications such as Prilosec, Prevacid, Nexxium and Protonix.

WHAT IS LPR?

Laryngopharyngeal reflux or LPR is a condition due to a small amount of stomach acid and enzymes making their way into your larynx, or voice box. The condition is treated with medications as well as behavior and diet changes. While LPR is not a dangerous condition, there have been reported cases of patients developing cancer from chronic reflux. The following is an information sheet to help you understand this condition.

If you've been diagnosed with LPR, please download this PDF helpful document from Dr. Sherman

WHO GETS LPR?

Laryngopharyngeal reflux commonly affects women. The average age of onset is 57. While the condition is made worse with obesity, it occurs very frequently in thin, tall women. A smaller percentage of men have LPR. The most common symptom is a gravelly voice present upon awakening and continuing throughout the day. With this comes ease of losing the voice, or voice fatigability. The sensation of “a lump in the throat,” or globus sensation, is also very common. This is due to hyperactivity of the muscle trying to hold the acid down in the esophagus. Finally, in response to laryngeal injury, the larynx produces a significant amount of mucus. Patients therefore often complain of significant throat clearing and the sensation of postnasal drip. Since the body cannot tell whether the “drip” is coming from the larynx or from the sinuses above, LPR is often confused with sinus symptoms or even asthma.

The above three symptoms, globus sensation, chronic throat clearing, and gravelly voice, are the most common presenting symptoms of LPR. Chronic throat pain, or the sensation of choking as well as chronic cough, may also be experienced. Heartburn is not commonly associated with LPR, and studies suggest that perhaps only 6% of patients with LPR have heartburn or gastroesophageal reflux disease (GERD).

If you believe you have GERD or LPR, please contact our office for an appointment.

LPR Acid Reflux Test - Restech Dx-pH Measurement System

CCENT has adopted the Restech Dx-pH Measurement System to detect acid reflux in the throat. "The Restech Dx-pH Measurement System allows us to easily measure stomach acid levels in the throats of patients and to correlate these levels with patient symptoms," said Dr. Bret Sherman, M.D., Ph.D., an Otolaryngologist at CCENT specializing in acid reflux disorders. "It is the easiest, most comfortable, and most reliable procedure available to measure acid levels in the upper airway of patients. The system vastly improves treatment as we are now able to determine exactly when and how much stomach acid reaches the throat. This leads to significantly better healthcare for our patients with throat and voice problems."

Patients are first seen by a CCENT ear, nose and throat specialist or speech pathologist because of throat irritation or voice problems. If an initial examination indicates voice pathology, the Restech Dx-pH Measurement System can be used to determine whether stomach acid is refluxing into the larynx. If acid reflux is indeed present, the correct drug treatment plan can be prescribed. If no acid is detected in the upper airway, a different cause for symptoms can be investigated. Prior to the Restech Dx-pH Measurement System, patients were routinely prescribed drug treatments because there were no accurate tests to determine whether stomach acid was refluxing into the upper airway and throat.

Restech Dx-pH Measurement System

The Restech Dx-pH Measurement System is a revolutionary system that comfortably measures pH in the airway. Gastric reflux in the upper airway, or laryngopharyngeal reflux, commonly takes a gaseous form that cannot easily be measured using conventional technology. The miniaturized pH sensor at the tip of the Dx-pH Probe is the only sensor able to measure pH in this area. By measuring such pH levels, the Dx-System enables physicians to determine the existence of laryngopharyngeal reflux and to correlate the reflux to various patient symptoms.

The Restech Dx-pH Measurement System sends measurements wirelessly to a miniature recording device which is easily carried by the patients during the test period, providing a simple and effective way to monitor reflux. Upon completion of the testing period (usually 24 hours), the patient returns to the physician's office where the device is plugged into a computer and measurements are downloaded for evaluation.

The Dx-pH Probe is 1.5mm in diameter and rests at a comfortable position in the back of the throat behind the soft palate and does not disrupt normal activity or eating. This allows patients to carry on normal, everyday behavior including eating, exercise, work, bathing, and sleeping with minimal disruption to their lives.

About Restech

Restech is a leader in engineering world class medical technologies that provide comfortable, reliable solutions to assist physicians in the diagnosis of reflux related health problems quickly and reliably. The innovative engineering team at Restech is led by professionals with over two decades experience each in medical device development. Together, the Restech staff hold over 30 patents in the areas of sensor technology, data recording & monitoring systems, and other medical devices.

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