Altman reviewed clinical practice guidelines for reflux disease in an abstract published in The Laryngoscope , in which he and his co-authors noted that most contributions to the guidelines came from gastroenterologists and not otolaryngologists ; Diagnosing by symptomology and prescribing medication comprised the most common approach for uncomplicated GERD. Defining GERD versus LPR and long-term management of patients were more variable and define the basis for the controversy that continues today.
Altman said that once a diagnosis is reached, the first thing to do is educate the patient about reflux. Some people may be prone to reflux because of their anatomy and physiology, but they may also have diet and lifestyle behaviors that contribute.
The standard treatment regiment involves PPIs such as omeprazole Prilosec , lansoprazole Prevacid , rabeprazole Aciphex , pantoprazole Protonix and esomeprazole Nexium. Otolaryngologists who prescribe PPIs will also advise patients about dietary and behavioral changes that can help. Everyone talks about tests and the costs of health care. There are consequences of reflux in the esophagus, he added. If reflux is suspected, either based on physical evidence or partial response to medicine, some otolaryngologists advise doubling the dose of PPIs.
Otolaryngologists sometimes add an H2 blocker at bedtime, such as famotidine Pepcid or ranitidine Zantac , to boost the pharmacologic effect. Another factor to consider, said Dr. It is common for infants to spit up, but problems with breathing and feeding could be signs of a more serious health problem. A doctor should investigate these symptoms. Researchers are currently exploring possible links between silent reflux in children and recurrent ear infections and sinusitis.
Some symptoms, such as projectile vomiting or vomit that contains blood, could be indications of other health problems. Visit a health professional if these symptoms become evident. When acid reflux leads to persistent heartburn, occurring maybe twice a week for 3 weeks or more, this is known as gastroesophageal reflux disease, or GERD.
Silent reflux, or laryngeal-pharyngeal reflux LPR , is similar, but without the heartburn and indigestion. Many adults manage to control symptoms by adjusting their eating habits and making lifestyle changes. Medications to treat silent reflux, such as antacids, are available over the counter OTC. These can help prevent the acid from returning to the esophagus.
Some of these medications are available online. Click here for an excellent range with thousands of customer reviews. H2-blockers, a form of anti-histamine, might help , especially if a cough bothers the person at night. If antacids do not work, a doctor may prescribe a proton pump inhibitor PPI , such as omeprazole, to reduce stomach acidity.
A person with LPR can use these for between 4 weeks and 6 months. Reflux is common in children up to the age of 1 year , and only those who have difficulty feeding or breathing require treatment. In severe cases, or when another treatment has not been effective, tube feeding and surgery may be necessary. In infants, the muscular valves at the end of the food pipe are not fully developed.
These valves keep the contents of the stomach from flowing back into the food pipe. Individuals with LPR usually do well with proper diagnosis and treatment. It may take several months for this to happen. IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders.
Our original content is authored specifically for IFFGD readers, in response to your questions and concerns. If you found this article helpful, please consider supporting IFFGD with a small tax-deductible donation. IFFGD is a leader in the fight for more research to improve diagnostic and treatment options for gastrointestinal GI disorders. With donations from people like. Do I Need Another Endoscopy?
Question I underwent an endoscopic exam about 1 year ago and was diagnosed with gastroesophageal reflux disease GERD. This information is in no way intended to replace the guidance of your doctor. All Rights Reserved. About GERD. What is GERD? Laryngeal Pharyngeal Reflux. Share this page. Share on facebook. Share on twitter. Share on linkedin. But, as experts explained here at the American Academy of Otolaryngology-Head and Neck Surgery Foundation Annual Meeting, an array of options is out there, many of them non-pharmaceutical.
An array of treatment options exists for LPR, many of them non-pharmaceutical. LPR can lead to a variety of symptoms, including chronic mucosal injury, laryngitis, and granulomas, as well as pulmonary issues such as pneumonia, and can be a trigger for head and neck cancers, including esophageal cancer and laryngeal and pharyngeal squamous cell carcinomas.
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