OTORHINOLARYNGOLOGY
FACIAL PLASTIC SURGERY
HEAD AND NECK SURGERY
OTOLOGY AND OTOLOGIC SURGERY
ALLERY

Definition

Gastroesophageal Reflux Disease (GERD) occurs when there is backward flow of stomach contents up into the esophagus and throat. Normally, the lower esophageal sphincter (LES), a ring-shaped muscle at the opening of the stomach, acts as a valve. This valve allows food down into the stomach and prevents backward flow. When the LES opens at the wrong time, the acidic content of the stomach is allowed up into the esophagus, and results in GastroEsophageal Reflux Disease.

Symptoms 

GERD can present with many symptoms, typically a combination of: recurrent hoarseness, sore throat, difficulty swallowing, feeling of a “ball in the throat”, coughing (typically worse at night or on awakening), excessive throat secretions, and/or constantly clearing the throat. It can also cause heartburn or a bitter taste in the mouth. In some persons, it may be completely silent.

Treatment

The treatment of GERD consists of 3 stages:
1. Changes in lifestyle, 2. Medication, and 3. Surgery

1. Changes in lifestyle: this is by far the most important part of the treatment. Often, this alone helps relieve the symptoms of reflux. Try following the next steps as closely as possible (listed in order of importance).

• If you smoke, Quit


• Do not eat anything for at least 3 hours before lying down (an empty stomach is less likely to reflux into your esophagus)
• Raise the head of your bed 4 to 6 inches off the ground using bricks or blocks of cement (pillows will not work, as they will only bend your neck; the whole upper half of your body must be angled so that your esophagus has an incline, preventing stomach acids from going up into it).
• If overweight, lose weight
• Eat small meals that are high in protein and low in fat
• Avoid foods containing acid such as orange juice, lemonade and tomato products
• Other foods to avoid: garlic, onions, chocolates, caffeine, alcohol, cinnamon and any mint products

If all this implies a significant change in your lifestyle, you may be relieved to know that you may need to follow these steps exactly for only 4 weeks. After that time, once your symptoms have improved or resolved, you may start reintroducing the things you liked (e.g. coffee, orange juice, …) one at a time. If your symptoms recur, you’ll know that you need to stay away from those things.

2. Medication: You may have been told to take over-the-counter antacids such as Maalox or Tums. In more significant cases, a prescription medicine may be recommended (such as Prevacid, Prilosec, Propulcid, Tagamet or Zantac).

3. Surgery: This option, though very effective, is reserved for the more severe, refractory cases.