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Acid Reflux - gerd


Gastroesophageal Reflux Disease
(GERD, Acid Reflux)




A comprehensive forum that covers such topics as:
What is GERD (acid reflux)?
What causes GERD?
What are the symptoms of uncomplicated GERD?
What are the complications of GERD?
How is GERD diagnosed and evaluated?
How is GERD treated?


Laryngectomy and Reflux - Incidence of Reflux in Laryngectomees.
In the long-term, rates as high as 80% of reflux in laryngectomees (in pdf)
Consequences and treatment of reflux in laryngectomees

Emergency Care & Consumer Health
Topics Related to Reflux Disease (GERD)
Anatomy of the Digestive System
Barium Swallow
Cancer of the Esophagus
Gastroesophageal Reflux Disease (GERD) FAQs
Gastrointestinal Endoscopy
Hiatal Hernia
Understanding Heartburn/GERD Medications


Suggestions  & Information - acid reflux



Glenn E. Peters, M.D.
Director, Division of Otolaryngology
Head and Neck Surgery
University of Alabama at Birmingham, Birmingham, Alabama, USA


Q.  Doctor, in our meetings, there has been some discussion about why we can't bend over after eating and drinking because liquids and even some foods will run back up the esophagus. Please explain what has been done that creates this problem and if we need to adapt ourselves because it will always be that way?


A.  Let's talk about this reflux thing for a minute. Under normal circumstances, there are two muscular bands or sphincters in the esophagus which prevent reflux. One is located where the esophagus joins the stomach and the other is located behind the larynx at the beginning of the esophagus in the neck. The lower esophageal sphincter (LES) often becomes compromised when there is a hiatal hernia, a condition resulting from a weakness in the diaphragm which allows the stomach to slip up from the abdomen into the lower chest cavity. When this happens you get what is known as gastroesophageal reflux--the condition we all hear so much about in the media these days. The other sphincter, the cricopharyngeus or the upper esophageal sphincter (UES) prevents things from coming up the esophagus into the throat and mouth. This muscular ring takes its origin from the lower part of the larynx, a part called the cricoid cartilage. But guess what--you ain't got one no more since your cricoid was taken out when your larynx was removed. This leaves the upper part of your esophagus sort of flaccid and always open and this could result in the reflux of stomach contents up into your throat and mouth. About 80% of the general adult population has a hiatal hernia. So if you have a hiatal hernia and, in addition, have had a laryngectomy then you get a double whammy.


So what's a guy/girl to do? Gastroesophageal reflux is usually managed with medicine to stop the stomach from making acid, along with dietary and lifestyle modifications. Severe cases may require surgery to keep the stomach from slipping up into the chest. Taking care of reflux from the UES is more problematic, however. Simply knowing that this is a problem and its cause are probably the most important things. Avoid bending over when you have a full stomach after meals. You may also might try reducing the size of each individual meal and eat four or five times a day instead of the usual three. (From HeadLines newsletter)



Over the years since my larynx cancer was found, the thoughts on this have changed and expanded to many causes of larynx cancer and ONE of the big reasons is GERD, or basically, acid reflux.

If you have indigestion or acid washing up from your stomach into your throat (GERD), talk with your doctor. If you had this before your surgery, it will probably be more of a problem after. He may prescribe a medication that will help to reduce the acid.
Raising the head of your bed with blocks under the frame or using a wedge pillow on the bed can help to prevent the night time reflux. After a meal, avoid bending over, exercising, or lying down and let food and drink settle before bedtime.

I take my med on an empty stomach at least 1/2 hour before supper so I will be better protected at night.  For me, acid reflux is more likely to occur while sleeping or lying down and I get better results with this schedule.

A reminder: This is not a medicine you take so you can eat anything you want.  Eat the wrong foods and you may still have a problem and may need larger doses.  If you know certain foods give you a problem.  Be careful. Skip those.

Pat S.


comparison of drugs for acid reflux - ppi


Consumer Reports has given a great report comparing the proton pump inhibitor drugs that are most commonly prescribed. These drugs are very similar but some have differences in the way they react with other drugs. In general, they are all effective and most of the side effects could be caused by the lack of acid in the stomach...which is why you are taking it, to reduce acid.

A general cost comparison is charted and you might note that there are two that can be bought OTC, so if you are ever caught without your drug, you can buy a package of Omeprazole or Lansoprazole at a local drug store. Ask your doc if it would be ok as a substitute should you not have enough of your regular drug with you on vacation. 





What makes reflux worse?
Tobacco use
Fatty & fried foods
Tomato products
Citrus juice & fruits
Carbonated beverages
Reclining after eating
Eating large meals
Eating before going to bed
Heavy lifting
Bending over at the waist
Wearing tight clothing that constricts the mid-portion of the body
Carminatives (peppermint, spearmint, cinnamon, garlic, onions, rosemary, basil)
Note: Before you think this cuts out all food worth eating in life---just eat some of these items in moderation.


Lifestyle changes:
* Elevate your torso while sleeping. Elevate head of bed with bricks or blocks 4-6".
* Use a foam wedge. Pillows alone won't help---they only raise your head, which can put pressure on your esophagus.
* Avoid the foods listed above.
* Don't lie down for 2-3 hours after eating.
* Avoid large meals---try 5 or 6 small meals instead of 3 large ones.
* If you are over your ideal body weight, implement a sensible weight loss program.
* Sleep on your left side to help the stomach contents pool away from the esophagus.


* Liquid antacids are generally more effective than tablets; however, tablets may be more convenient at work or while traveling. Antacids are most effective if used before bed and after meals. They should not be used within one hour of taking prescribed anti-reflux medications or vitamins/minerals.
* H2 blockers such as Pepcid AC, Zantac, and Tagamet reduce the amount of acid produced by the stomach. H2 blockers do not completely eliminate stomach acid production and are more effective in treating peptic ulcers than in controlling throat and voice box symptoms resulting from reflux.
* Proton pump inhibitors such as Prilosec, Nexium, Aciphex, and Prevacid stop the production of stomach acid. The stomach enzyme pepsin does less harm to the lining of the esophagus, throat, and voice box when acidity is reduced. Proton pump inhibitors are most effective when taken an hour before a meal.


* Some forms of exercise can trigger acid reflux symptoms.
* High aerobic activities, like aerobics and running can put pressure on your stomach.
* Try walking briskly instead of jogging.
* Try gentle toning exercises like yoga or Pilates instead of lifting weights.


While stress isn't a cause of acid reflux disease, it can lead to behaviors that can trigger symptoms, like eating fatty foods or drinking too much caffeinated coffee.
Make time for yourself---read a book, watch a movie, garden, take a warm bath.


Research done by Vicki Metz




1.  In addition to the one-a-day prescription medications that do an excellent job of controlling reflux, it is a good idea to wait an hour after eating before lying down. After a laryngectomy, we are much more susceptible to stomach contents coming back up the esophagus if we lean over or assume a horizontal position. Since the upper esophageal sphincter is often weakened or missing, there is nothing to stop this reflux from coming up into the throat, so allowing time for the stomach to empty is helpful.
Tip of the Month...If you are having problems with reflux at night, try raising the head of your bed by several inches and don't eat or drink anything right before bedtime. You'll sleep better.


2.  A drug a lot of us take, Omeprazole (generic), is a proton pump inhibitor which reduces acid to keep reflux from putting acid in your throat. It is not a cancer cure, but could be considered as a possible cancer prevention medication. It is regarded as safe to take and 1 a day would not be out of line in preventing acid from washing up to irritate cancerous or pre-cancerous tissues.

3.  Anytime your throat is smaller, be it from surgery, swelling, irritation, acid reflux, yeast, whatever is causing the swallowing passage to be smaller, your usual gulp will not all go down .and you sealed off the back of the mouth as you swallowed, so it comes back up to the only place it can, through the nostrils.To help this, get a straw and use it to sip liquids. Sip some while you are chewing and mix the food so it doesn't jam up the passage. Swallow small amounts and be sure one is down before the next one comes after it.


Many of us learn to eat a little slower and sip, not gulp. Some also have it intermittently and adjust during bad times such as allergy season. Sinus drainage and allergies can cause irritation that is temporary. Acid reflux has caused mine to swell and make me have to be careful and reminded me to get back on Prilosec or the equivalent.
Pat S. AL
4.  I use my recliner very often, and have wedge shape pillow etc. I use them because of the ACID REFLUX which I have since this surgery.
Antal K. FL
5.  I was having trouble with a leaking prosthesis within a week to 6 weeks of insertion. They gave me Nystatin and Prevacid for acid reflux. I have had this prosthesis in now for 7 or 8 months. I had no indication that I had acid reflux but this has taken care of me
Gary S. VA




For elevating my head to avoid reflux, I use a wedge pillow about 12" high at the thickest end. I put a pillow on top of that. I prefer this to a tilted bed as we have no foot board and the mattress doesn't slide down toward the foot of the bed. Also, since I am the only one affected--my husband can lie on a flat bed. I just take this with me whenever we go away from home for the night where getting an extra pillow isn't always easy. See the descriptions and photos of pillows in Everyday Living. (Vicki Metz)





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