Acid reflux is a common issue most adults will experience in their lifetimes. But how can you tell the difference between ordinary reflux and the symptoms of gastroesophageal reflux disease (GERD)? Sometimes, individuals do not discover they have GERD until problems arise. But usually, GERD is characterized by persistent, reoccurring acid reflux over a long period of time.
When reflux occurs, the acidic contents of the stomach come back up into the esophagus, which is usually prevented by the lower esophageal sphincter. This stomach acid touching the sensitive tissues lining the throat and esophagus results in a burning sensation, which is why acid reflux is often characterized by the sensation known as heartburn. The lower esophageal sphincter in people with GERD does not close effectively, which is why they experience frequent and disruptive heartburn and acid reflux.
A similar problem is laryngopharyngeal reflux (LPR), during which the contents of the stomach reflux all the way beyond the upper esophageal sphincter, into the back of the throat and occasionally even the back of the nasal airway. Adults who experience LPR complain their throat has a bitter taste, a sensation of burning, hoarseness, difficulty swallowing, or postnasal drip. Many people with LPR do not experience heartburn. When children suffer from LPR, they may experience breathing problems such as: cough, hoarseness, stridor (noisy breathing), croup, asthma, sleep-disordered breathing, feeding difficulty (spitting up), turning blue (cyanosis), aspiration, pauses in breathing (apnea), apparent life-threatening event (ALTE) and even a severe deficiency in growth. Proper treatment of LPR, especially in children, is critical.
GERD and LPR can occur at the same time. They can be caused by physical problems such as an abnormal lower esophageal sphincter muscle, hiatal hernia, abnormal esophageal contractions and slow emptying of the stomach. Lifestyle factors include destructive habits (overeating, alcohol and tobacco abuse), diet (chocolate, citrus, fatty foods, some spices), and pregnancy. Young children experience these problems due to the developmental immaturity of their upper and lower esophageal sphincters. Fortunately, most infants grow out of GERD or LPR by their first year. It is important, however, to monitor children for any lasting damage.
If you or your child experience GERD or LPR symptoms, how can an ENT help?
A gastroenterologist will typically be the first to provide treatment for GERD. But damage caused by reflux can often result in problems in the ear, nose, or throat, including hoarseness, laryngeal nodules in singers, croup, airway stenosis (narrowing), swallowing difficulties, throat pain, and sinus infections. Many of the complications of these diseases require an otolaryngologist’s expert care. Through a combination of lifestyle changes and medication, GERD and LPR are usually very treatable conditions.