GASTROESOPHAGEAL REFLUX DISEASE (GERD)
What is GERD?
The stomach contains very strong acids for digesting and breaking down complex foods to aid absorption. However, sometimes this acidic stomach content can flow back up into the esophagus, the tube which connects the throat to the stomach. This is known as Acid Reflux. Acid reflux is a normal occurrence that happens to everyone occasionally. However, acid reflux on a constant basis causes irritation to the lining of the esophagus and can cause Gastroesophageal Reflux Disease (GERD).
What are the potential causes of GERD?
Stomach acid is usually kept inside the stomach by a muscular valve at the lower end of the esophagus. GERD occurs when this valve is weakened, or if the stomach pushes up through a hole (hernia) in the diaphragm muscle. This leads to acid regurgitation, when acidic stomach contents rise to the throat or mouth. Symptoms can result from direct irritation by acid and stomach enzymes, or by reflexive tightening of throat muscles.
Who is more likely to experience GERD?
The following factors may increase your risk of getting GERD:
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Ageing
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Pregnancy
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Obesity
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Cigarette smoking
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Also, overeating or having a high dietary intake of:
• Spicy foods
• Fatty foods
• Sugary foods
• Caffeinated/carbonated drinks
• Alcohol
GERD Symptoms
Symptoms of GERD may include:
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Difficulty or pain swallowing and vocalizing
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Nausea
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Persistent Sore throat
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Hoarseness of voice
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Coughing and shortness of breath
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The sense of a “lump in the throat”, also known as globus, may result from chronic reflux laryngitis, or increased tension in the upper esophageal muscles behind the voice box.
Increased secretions in the throat can result in habitual throat clearing. Continuous throat clearing can cause further irritation or damage to the throat. A patient with nighttime reflux may awaken with a sore, irritated throat and a gravelly voice.
It is not uncommon for GERD patients to experience heartburn, a burning sensation that rises from the stomach or lower chest towards the neck, commonly occurring after eating food. Non-cardiac chest pain may also be experienced.Taking note of these symptoms, and when they occur on a regular basis can help your doctor to diagnose GERD.
Diagnosis of GERD
After taking a detailed history, the doctor will perform a nasoendoscopy to observe the affected area around the voice box to look for signs of swelling or irritation to diagnose GERD.
The photo below indicating GERD shows redness and swelling of the posterior (back) area of the voice box, which leads to the esophagus.
From this examination, the doctor can gauge the severity of reflux and assess what treatment is most appropriate.
Endoscopic photo comparison of the larynx
Larynx clear of GERD
Larynx affected by GERD
GERD Treatment Options
Treatment for GERD is directed at keeping the stomach contents in the stomach, and neutralizing the acid when reflux occurs.
Certain lifestyle and dietary changes such as reducing weight and avoiding acidic reflux-inducing foods can reduce the likelihood of acid reflux.
Treatment options can include usage of medications such as antacids and PPIs (Proton Pump Inhibitors), and in rare severe instances, surgery to the stomach.
Related Conditions
If you are experiencing symptoms that do not align with GERD, Euan’s ENT Surgery & Clinic also provides treatment for the following throat related conditions:
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Tonsils & Adenoids
If you would like to seek consultation for GERD with Euan’s ENT Surgery & Clinic, please Contact Us to make an appointment.
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