Gastro-esophageal reflux disease (GERD) also called heartburn or acid reflux disease. Gastro-esophageal reflux is a burning sensation in the chest that may occur after eating, bending, stretching, exercising, and lying down. GERD occurs when the contents of the stomach travel back up into the esophagus. This can happen when the lower esophageal sphincter (LES) valve, which controls the passage of food from the esophagus to the stomach, fails to close correctly. Almost all individuals have experienced reflux (GER), but are defined as a disease (GERD) when reflux happens often over a long period of time. If the contents of the stomach and upper digestive tract reflux all the way up the esophagus, beyond the upper esophageal sphincter (a ring of muscle at the top of the esophagus), it may be referred to as laryngopharyngeal reflux disease (LPR). The reflux can reach the back of the throat and possibly the back of the nasal airway. This reflux can affect the larynx and cause symptoms such as coughing, hoarseness, inflammation, and sore throat, LPR is possibly associated with laryngeal cancer due to the chronic irritation but more commonly may be associated with frequent coughing, throat clearing, excess mucus and phlegm, and the sensation of a lump in the throat. Many patients with LPR do not experience heartburn. Proper treatment of LPR, especially in children, is critical.
GERD and LPR may occur together but patients can have GERD alone (without LPR) or LPR alone (without GERD). If you experience any symptoms on a regular basis (twice a week or more), then you may have GERD or LPR and should be evaluated by your primary care provide, a gastroenterologist or ENT specialist.
Your doctor may be able to diagnose gastroesophageal reflux disease, or GERD, from your description of symptoms. The doctor may also suggest tests to rule out other possible causes of your symptoms, to monitor the degree of damage, or to determine the best treatment for you.
An X-ray of your upper digestive system (sometimes called a barium swallow or upper GI series) involves drinking a chalky liquid that coats and fills the inside lining of your digestive tract. Then X-rays are taken of your upper digestive tract. The coating allows your doctor to see a silhouette of your esophagus, stomach and upper intestine (duodenum).
Endoscopy is a way to visually examine the inside of your esophagus and stomach. During endoscopy, your doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat. Oropharyngeal pH probe testing is a test where a small probe is worn for 24 hours to test the pH in the back of the throat to see if reflux is contributing to symptoms.
There are ear, nose, and throat problems that are caused by reflux reaching beyond the esophagus, such as hoarseness, laryngeal nodules in singers, croup, airway stenosis (narrowing), swallowing difficulties, throat pain, and sinus infections. These problems require an ENT specialist, head and neck surgeon, or a specialist who has extensive experience with the tools that diagnose GERD and LPR. Complications of GERD and LPR, include: sinus and ear infections, throat and laryngeal inflammation and lesions, as well as a change in the esophageal lining called Barrett's esophagus
Treatment for heartburn and other signs and symptoms of GERD usually begins with over-the-counter medications that control acid. If you don't experience relief within a few weeks, your doctor may recommend other treatments, including prescription medications. Most people with GERD or LPR respond favorably to a combination of lifestyle changes and medication. In severe cases and those that do not respond to medication, surgery may be recommended.
If you have both GERD and asthma, managing your GERD may help control your asthma symptoms. Studies have shown that people with asthma and GERD saw a decrease in asthma symptoms (and asthma medication use) after successfully treating their reflux disease.
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