Although GERD also may be a cause of asthma, it is more likely that it precipitates asthmatic attacks in patients who already have asthma. Although chronic cough and asthma are common ailments, it is not clear just how often they are aggravated or caused by GERD. The liquid from the stomach that refluxes into the esophagus damages the cells lining the esophagus. The body responds in the way that it usually responds to damage, which is with inflammation (esophagitis). The purpose of inflammation is to neutralize the damaging agent and begin the process of healing.
Dysfunction of the lower esophageal sphincter
An LES that doesnâ€™t function properly allows stomach acids and food particles to flow back up your esophagus to your throat. Sometimes, people confuse the symptoms of heart attack with symptoms of acid reflux disease.
Acid Laryngitis – Occasionally, gastric juice may reflux through the esophagus and upper esophageal sphincter and spill into the larynx, or voice box. The ensuing inflammation causes laryngitis and hoarseness. Damage to the larynx is sometimes visible through a scope. If you have occasional acid reflux, lifestyle changes can help. Lose excess weight, eat smaller meals, don’t eat two to three hours before bedtime, raise the head of your bed, and avoid foods that seem to trigger heartburn – such as fried or fatty foods, chocolate, and peppermint.
If treatment relieves the symptoms completely, no further evaluation may be necessary and the effective drug, the H2 antagonist or PPI, is continued. As discussed previously, however, there are potential problems with this commonly used approach, and some physicians would recommend a further evaluation for almost all patients they see. A third type of endoscopic treatment involves the injection of materials into the esophageal wall in the area of the LES. The injected material is intended to increase pressure in the LES and thereby prevent reflux. In one treatment the injected material was a polymer.
The mean DeMeester Score was about 40. On the GERD Health-Related Quality of Life Questionnaire, patients scored about 24 while on medical therapy and 31 while off. They reported moderate to severe heartburn and regurgitation.
- People with a hiatal hernia may be more likely to have acid reflux.
- In addition to bolstering positive device data, the results of this ongoing randomized study suggest that it may be time to rethink the treatment algorithm for patients who donâ€™t respond optimally to medical therapy, Dr. Bell said in an interview .
- Capsule pH testing is expensive.
- As a result, acid more easily presses against the LES and flows into the esophagus.
Acid reflux, a symptom of gastroesophageal reflux disease (GERD), can cause nausea. Recognizing GERD symptoms and treating them under the supervision of your doctor can help you avoid acid reflux-induced nausea.
Moreover, the effectiveness of drug treatment can be monitored with 24 hour pH testing. Who should consider surgery or, perhaps, an endoscopic treatment trial for GERD? (As mentioned previously, the effectiveness of the recently developed endoscopic treatments remains to be determined.) Patients should consider surgery if they have regurgitation that cannot be controlled with drugs. This recommendation is particularly important if the regurgitation results in infections in the lungs or occurs at night when aspiration into the lungs is more likely.
We may also provide surgery to eliminate GERD, especially for patients who have a large hiatal hernia or canâ€™t take medication due to side effects. Not everyone with GERD has the typical symptoms, which are heartburn and regurgitation soon after eating. Up to 20% may have different symptoms, such as coughing or chest pain, a sore throat or hoarse voice, or even frequent sinus infections.
If you have acid reflux, stomach acid gets into your throat. This may make you salivate more. If this acid mixes with the excess saliva during reflux, youâ€™re experiencing water brash.
But if you have a hiatal hernia, it is easier for acid to move up into your esophagus. If you are sounding a little hoarse and have a sore throat, you may be bracing for a cold or a bout of the flu. But if you’ve had these symptoms for a while, they might be caused not by a virus but by a valve-your lower esophageal sphincter. That’s the muscle that controls the passage between the esophagus and stomach, and when it doesn’t close completely, stomach acid and food flow back into the esophagus.
Normally, the LES is located at the same level where the esophagus passes from the chest through a small opening in the diaphragm and into the abdomen. (The diaphragm is a muscular, horizontal partition that separates the chest from the abdomen.) When there is a hiatal hernia, a small part of the upper stomach that attaches to the esophagus pushes up through the diaphragm. As a result, a small part of the stomach and the LES come to lie in the chest, and the LES is no longer at the level of the diaphragm. affect different individuals or even in the same individual at different times. A small number of patients with GERD produce abnormally large amounts of acid, but this is uncommon and not a contributing factor in the vast majority of patients.