What Is GERD?
Gastroesophageal reflux, often referred to as GERD, occurs when acid from the stomach backs up into the esophagus. Normally, food travels from the mouth, down through the esophagus and into the stomach. A ring of muscle at the bottom of the esophagus, the lower esophageal sphincter (LES), contracts to keep the acidic contents of the stomach from “refluxing” or coming back up into the esophagus. In those who have GERD, the LES does not close properly, allowing acid to move up into the esophagus. The stomach acid irritates the sensitive tissue lining the esophagus and throat, which can cause a burning sensation known as heartburn. In some cases, reflux can be SILENT, with no symptoms until a problem arises. Almost all individuals have experienced reflux (GER), but the disease (GERD) occurs when reflux happens on a frequent basis often over a long period of time.

What Are The Symptoms of GERD And LPR?

During gastroesophageal reflux, the acidic stomach contents may reflux all the way up the esophagus and into the back of the throat and possibly into the back of the nose. This is called laryngopharyngeal reflux (LPR), which can affect anyone. Patients with LPR often complain of chronic throat pain, that the back of their throat has a bitter taste, or of the sensation that something is “stuck” in the throat. Other symptoms or sequelae include frequent throat clearing, chronic cough, hoarseness, difficulty swallowing, bad breath, chest pain, laryngeal inflammation and lesions, breathing problems and a change in the esophageal lining called Barrett’s esophagus, which is a serious complication that can lead to cancer. Proper treatment of LPR can address both a health issue and a quality of life issue.

Diagnosing And Treating GERD And LPR

Your primary care physician will often refer you to an otolaryngologist for evaluation, diagnosis, and treatment if the symptoms affect the ears, nose or throat. LPR can frequently be diagnosed by a physical examination and the patient’s response to a trial of treatment with medication. Simple tests that may be needed include an endoscopic examination (a long tube with a camera inserted into the nose, throat, voicebox, or esophagus), biopsy, x-ray, 24 hour pH probe testing for acidic reflux into the esophagus or throat. Screening endoscopic examinations can often be performed by your otolaryngologist in the office with local anesthesia, who may refer you to a gastroenterologist who will use some form of sedation and occasionally anesthesia for more extensive testing. Most people with GERD respond well to a combination of lifestyle changes and medication:

• eliminate caffeine, alcohol, chocolate and peppermint from your diet


• stop smoking


• lose weight


• eat at least 3 hours before going to bed and 2 hours before exercising


• elevate the head of the bed by 4-8 inches


• medications that could be prescribed include: antacids, histamine antagonists (e.g. Pepcid), and proton pump inhibitors (e.g. Prilosec). Some of these products are now available over-the-counter and do not require a prescription.


• On occasion, the symptoms do not completely respond to lifestyle changes and medication and surgery is recommended (this surgery is performed by a general surgeon, not an otolaryngologist).

IT IS ESSENTIAL THAT YOU FOLLOW YOUR DOCTOR’S RECOMMENDATIONS; FREQUENTLY, 3 MONTHS OF STRICT ADHERENCE TO THE LIFESTYLE CHANGES OR COMPLIANCE WITH MEDICATIONS ARE REQUIRED FOR SYMPTOM RESPONSE.

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