Reflux

Gastro-oesophageal reflux (G.O.R.D), stomach acid content refluxes backwards up into the esophagus, occasionally reaching the breathing passages, causing inflammation and damage to the esophagus, as well as to the lung and larynx (the voice box).

 

Causes:

 

Gastro-oesophageal reflux also known as acid reflux can range in severity from being an occasional, to being severe. It occurs when the stomach reflux back up into the eosphagus or mouth.

 

Medical Symptoms:

 

The voice box lining is extremely sensitive to stomach contents. Acid reflux causes redness and swelling of the larynx. This creates a sensation of irritation or mucus in the throat which people may mistake for post-nasal drip. Coughing and chronic throat clearing also commonly occur. Less commonly people may experience pain or difficulty swallowing

Many people with LPR do not experience the classic symptoms associated with GORD including heartburn, chest pain or an acidic taste in the mouth. In fact 50% of people with LPR have no other symptom except irritation in the throat and/or cough. Often these symptoms are worse during the day (when upright) and after certain foods (see below) which may trigger an acid reflux episode.

 

Medical Treatment:

 

Gastro-oesophageal reflux disease is treated according to its severity. Mild acid reflux include diet changes such as avoid acid reflux induced foods eg. Alcohol, caffeine, chocolate. Peppermint and fatty foods. Avoid large and late meals, lying down  with a full stomach may increase the risk of acid reflux. Antacids are commonly used for short-term relief of acid reflux.

More severe acid reflux suffers may use: Histamine antagonists reduce production of acid in the stomach. But can be less effective than proton pump inhibitors (PPI’S).

Proton Pump Inhibitors (PPIs) are commonly prescribed medication for patients that have long-lasting reduction of stomach acid production.

 

  • Somac (pantoprazole);
  • Pariet (rabeprazole);
  • Losec (omeprazole);
  • Nexium (esomeprazole);
  • Zoton (lansoprazole).

 

Proton pump inhibitors are safe, although they may be expensive, especially if taken for a long period of time. The goal of treatment for GERD is to take the lowest possible dose of medication that controls symptoms and prevents complications.

Surgical treatment is reserved for people who remain resistant to medical therapy. A Gastroenterologist will make this decision.

 

Investigations:

 

A fibre optic laryngoscope is inserted in our procedure room under local anaesthetic to exclude any suspicious pathology such as tumours. Laryngitis due to reflux has a particular appearance on endoscopy. Another unique test which is currently undergoing trial is a nuclear medicine study evaluate the extent and volume of reflux into the throat.