President Obama was diagnosed with acid reflux just prior to the New Year, following a persistent week’s long sore throat. http://goo.gl/aYU79T He underwent flexible laryngeal endoscopy which revealed swelling at the back of his larynx, which was consistent with laryngopharyngeal reflux (LPR). Inflammation occurs here because that is where the swallowing and talking passages separate in the throat.
The most common symptoms of LPR are: hoarseness, sore throat (burning, raw, hot, etc.), mucous accumulation in the throat, frequent throat clearing, and a sense that something is in the throat (globus sensation). This is sometimes referred to as “silent reflux” as a patient may not have symptoms despite findings on physical exam. GERD (gastroesophageal reflux disease) is a separate entity from laryngopharyngeal reflux (LPR), and symptoms could include heartburn, regurgitation, chest pain and difficulty swallowing. The American College of Gastroenterology recommended lifestyle strategies to manage GERD, and some of the treatment considerations are the same for LPR.
3 key lifestyle modifications are recommended as a first approach to treating GERD:
- Lose weight if you are overweight or recently gained weight.
- Elevate the head of your bed 6-8” at night with blocks or a foam wedge if you suffer from night-time GERD.
- Avoid high-fat meals within 2-3 hours of bedtime and lying down.
Wide-ranging dietary restrictions are no longer recommended, such as eliminating alcohol, caffeine, citrus, and spicy foods, as there is no research showing benefit. Now, it is encouraged that you identify what are your particular reflux triggers, and modify accordingly. Remembering it is not always the most obvious offenders.
If these lifestyle recommendations do not resolve the reflux symptoms, H2 blockers, antacids, and proton pump inhibitors (PPIs) are then introduced. Over the counter and prescription H2 blockers reduce acid production and provide temporary relief (Pepcid, Zantac, etc.). Antacids neutralize stomach acid and relieve mild symptoms (Maalox, Mylanta, Alka-Seltzer, etc.). PPIs are the most effective at healing esophageal inflammation and heartburn relief (Prevacid, Prilosec, Nexium, Aciphex, Dexilant, etc.). PPIs should be taken 30-60 minutes before meals. The initial course of treatment may last 3-6 months.
Talk to your doctor if you are experiencing any of the symptoms described above. Untreated LPR can interfere with your vocal recovery.
