“Your throat feels sore because a little bit of acid is coming up from the esophagus and irritating the throat,” says Gina Sam, MD, MPH, a gastroenterologist and the director of the Mount Sinai Gastrointestinal Motility Center in New York, NY. Unexplained hoarseness may be caused by stomach acid moving up to your larynx, or voice box, and tends to be more noticeable in the mornings when it’s had all night to travel while you were lying down. These natural remedies for heartburn relief may help silent acid reflux too. Gastroesophageal reflux disease (GERD), or acid reflux, can cause post-nasal drip.
If avoidance is impractical, the next step is medication. Some patients can get relief by taking over the counter non-sedating antihistamines. Some require prescription strength medications such as steroid or antihistamine nasal sprays.
Elevating the head of the bed is helpful in reducing nighttime symptoms of acid reflux, such as coughing and choking. Patients are also advised not to eat within three hours prior to bedtime to further reduce the causes of acid reflux. The connection between GERD and rhinosinusitis, or CRS, is better established in children than adults. In a groundbreaking study published in the September 1999 issue of “Otolaryngology — Head and Neck Surgery,” 89 percent of children with chronic sinusitis who were treated for GERD with acid suppressive therapy were able to avoid sinus surgery.
Implication in these disorders has fostered speculation that GER plays a role in other upper airway maladies such as chronic sinus disease (CSD). If GER were shown to play a significant contributory role in CSD, it might change the way these children are evaluated and treated. Treatment of GER in children with medically refractory CSD might reduce disease burden, improve quality of life, avoid prolonged antibiotic therapy, and obviate the need for sinus surgery. Because of the potential risks associated with sinus surgery, which is rarely curative, and unknown effects on facial growth and development, the consensus is that all medical treatment options should be exhausted before considering elective sinus surgery in children.
If medication is not helpful, allergy desensitization shots can be administered. These shots are given regularly over a period of several years in order to build up a tolerance to the antigen and essentially cure or eliminate the allergic condition. For example, if GERD causes hoarseness, narrowing of the airway, swallowing difficulties, throat pain and sinus infections, those are the areas treated specifically by an ENT physician who specializes in treating diseases of the head and neck. But in many cases, your symptoms can be treated through home remedies, OTC medications, and a treatment plan developed with your doctor to address its specific causes. Sinusitis is considered chronic after symptoms last for more than 12 weeks.
Normally, these sphincters keep the contents of your stomach where they belong — in your stomach. But with LPR, the sphincters don’t work right. Stomach acid backs up into the back of your throat (pharynx) or voice box (larynx), or even into the back of your nasal airway. It can cause inflammation in areas that are not protected against gastric acid exposure.
- Even after treatment of a sinus infection, inflammation can persist.
- Your stomach will thank you.
- A gastroenterologist, or GI physician, who specializes in the digestive tract and other gastrointestinal functions, can diagnose either condition which may include a physical exam, endoscopic exam, or pH monitoring.
- The natural draining pathways of the sinuses are relatively small openings that are hidden within narrow corridors.
- Post-nasal drip can result from abnormalities in other structures involving the nose and sinuses.
What’s more, it was routine to strip the sinuses of that mucus-producing tissue in an effort to prevent trapped secretions from building up again. It turns out that these patients often continued to be troubled by recurrent sinus infections or crusting and bleeding in the nose. This is because those hair cells that line the sinuses all move together in a specific, coordinated fashion to move secretions only toward the area of the natural openings, no matter how many other exit paths there are in the sinus. The natural draining pathways of the sinuses are relatively small openings that are hidden within narrow corridors. While this may be an advantage in that foreign particles or insects that we inhale don’t end up getting inside our sinuses, it also means that it doesn’t take much swelling in the nose before these passageways are blocked.
Many conditions that result in a bad smell in the nose have dehydration as their root cause. How much liquid someone needs each day depends on their age, activity levels, and diet, among other factors.
Second, restrict all highly acidic foods and beverages. If you have reflux, the only thing you should drink out of a bottle is water, and alkaline water is best.
Most infants grow out of GERD or LPR by the end of their first year, but the problems that resulted from the GERD or LPR may persist. Conversely, acid reflux irritates the larynx and may cause a reflex constriction of the bronchi. In an individual, it is difficult to confirm that reflux causes asthma.
“Wheezing or a cough that mimics asthma or bronchitis can be caused by acid reflux moving from the stomach to the lungs,” says Evan Dellon, MD, the director of the Center for Esophageal Diseases and Swallowing at the University of North Carolina School of Medicine in Chapel Hill, NC. On the other hand, wheezers and coughers can sometimes make themselves more prone to reflux, says Dr. Dellon, because the actions put pressure on the belly and push stomach acid upward. GERD and LPR can be diagnosed or evaluated by a physical examination and the patient’s response to a trial of treatment with medication. Other tests that may be needed include an endoscopic examination (a long tube with a camera inserted into the nose, throat, windpipe, or esophagus), biopsy, x-ray, examination of the esophagus, 24 hour pH probe with or without impedance testing, esophageal motility testing (manometry), and emptying studies of the stomach. Endoscopic examination, biopsy, and x-ray may be performed as an outpatient or in a hospital setting. Endoscopic examinations can often be performed in your ENT’s office, or may require some form of sedation and occasionally anesthesia.
Most outer ear infections respond well to treatment, but rare complications can occur. The infection can potentially spread to the soft tissues of the face and neck, which requires oral or even IV antibiotics. In patients with diabetes or a compromised immune system, the infections can become aggressive and invade the bone of the skull and ear. This is a very infrequent occurrence but needs to be managed with an emergent surgical procedure.
Still, they conclude that “it might be prudent” to consider GERD in cases of chronic sinusitis that do not improve after standard treatment. Eight of the patients with sinusitis experienced heartburn at least once a week and nine had levels of acid in the esophagus comparable to the GERD patients, the report indicates. For 3 months, all sinusitis patients, regardless of whether they had GERD symptoms, took omeprazole before breakfast and supper each day. Some people respond well to self-care and medical management.