Tell Me About Dietary Modifications
You may wish to avoid coffee and tea, carbonated beverages, alcohol, fatty fried foods, spicy food, citrus fruits and juices, tomato juice, orange juice, and grapefruit juice, tomatoes, onions, peppermint, spearmint, chocolate, cheeses, and eggs.
Avoid large meals, especially in the evenings. Do not lie down right after eating. Allow three to four hours after supper and lying down. Make the mid day meal the heavier meal of the day and eat small, well-balanced meals.
After spending a year moping about turning 50, I finally went in to speak with Dr. Schrader about an upper Blepharoplasty . Every time I looked in the mirror i saw a tired unrecognizable me. With my busy professional schedule and mommy obligations I couldn’t imagine working in a procedure like this into my schedule. Dr. Schrader was so confident that i’d love it and went out of her way to make it work for me. It’s been over 3 months now since my surgery and i couldn’t be happier. Dr. Schrader, Michelle, and other staff made it such a worthwhile experience.
How Often Is Gerd Misdiagnosed As Sinusitis
LPR/GERD is often misdiagnosed as sinusitis, simply because of the post-nasal drip, says Dr. Koufman.
Too much throat mucus is one of the most common symptoms of LPR.
What is the function of mucus? It creates a protective barrier for the nasal membranes, as well as the membranes that line the throat.
When irritation is present from reflux, generally more mucus is produced, almost as if the body was trying to better protect itself, says Dr. Koufman.
About half of Dr. Koufmans patients, who have been diagnosed with sinus disease by other doctors, dont have sinusitis.
She adds, Unfortunately, sometimes I see such patients after theyve had unsuccessful and ineffective sinus surgery.
Cut Back On Dairy Products
Many people suffering from post-nasal drip swear that giving up or at least cutting back on dairy products like milk, yogurt, and cheese reduces mucus production and eases their symptoms. No studies have proven definitively that the strategy is helpful, but personal stories abound.
“I don’t think it’s an old wives’ tale,” said Dr. Liberatore. “There’s not great data, but patients have shared with me how much better they feel when they eliminate dairy.”
A 2018 literature review published in the journal Archives of Disease in Childhood suggested that while studies do not seem to associate dairy with increased mucus production, a couple studies have suggested that what people think is an increase in mucus production after eating dairy is actually the result of the dairy making the saliva thicker and more viscous .
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Treatment For Deviated Septum
A deviated septum is treated by a surgical procedure called a septoplasty. There is a newer less invasive form of septoplasty where an endoscope is used to remove the deviated septum. An endoscopic septoplasty can be assisted by TRACT, a newly approved balloon that when inflated in the nose, destabilizes the septum and makes the endoscopic removal easier. Dr. Atkins was the second surgeon in the country to perform a septoplasty using TRACT and has had great success using this technique. Many septoplasties are now performed in the office under IV sedation, so the patient doesnt have to go to the hospital.
Treatment For Silent Reflux
With medication, most patients will begin to notice some relief in their symptoms in about six weeks. However, it is generally recommended that the medication be continued for several months. If the symptoms completely resolve, then you can start tapering off the medication. Some people will be symptom free without the medication, while others may have relapses which require resuming treatment.
Surgery to prevent reflux is rarely needed. Diet modifications and current medications have allowed LPR to be treated without surgery most of the time. If surgery is needed, it involves tightening the muscle at the top of the stomach to prevent the reflux from happening. This is done by a general surgeon in consultation with a gastroenterologist.
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Can Postnasal Drip Cause Gerd
Its unlikely for postnasal drip to cause GERD. As mentioned above, GERD is primarily a problem with the muscles that separate your esophagus from your stomach. But many things can increase the irritation in your esophagus or trigger the overproduction of stomach acids.
Mucus from postnasal drip is just one of the many fluids that pass through the esophagus each day. Mucus production triggered by viral illnesses or other infections can irritate the lining of the throat, making it more sensitive to damage from stomach acids. You may also develop a cough with postnasal drip that could further irritate the tissue in your esophagus.
So, although postnasal drip probably wont cause GERD, it can still leave you with an uncomfortable feeling in your esophagus.
Tell Me About Medical Treatment For Gerd
Medical treatment is based on neutralizing stomach acid, reducing or eliminating stomach acid and improving gastric emptying. Neutralizing stomach acid can be achieved by using over-the-counter antacids in liquid or tablet form such as Sucralfate suspension, Maalox, and Ryopan. Reducing or eliminating stomach acids can be achieved with H-2 blockers, which are drugs that depress acid production, such as Cimetadine , Ranitidine , or Famotidine . These are also now available over-the-counter at lower dosage.
Antacids and H-2 blockers should be taken one hour apart as antacids may reduce the other drugs effectiveness. New drugs like Omeprazole and Nexium completely stop stomach acid production. These drugs are generally prescribed for short-term use.
Improving gastric emptying can be undertaken by Cisapride, Metoclopromide, Bethanachol, Proton pump inhibitors , and other drugs. These drugs increase the squeezing action of the esophagus and tighten the esophageal sphincter, in addition to making the stomach empty faster.
Dr. Lupa was friendly, efficient, and candid. He did a great job explaining the procedure and checking in with me during the procedure about my pain level.
Why Choose Our Specialists?
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Who Can Treat Gerd And Lpr
It may seem odd, but an Ear, Nose, Throat physician is the specialist to see for the treatment of GERD and LPR. A gastroenterologist, or GI physician, who specializes in the digestive tract and other gastrointestinal functions, can diagnose either condition which may include a physical exam, endoscopic exam, or pH monitoring. However, an ENT specialist is trained to treat the problems caused by GERD and LPR that can extend beyond the GI tract into the ear, nose and throat.
For example, if GERD causes hoarseness, narrowing of the airway, swallowing difficulties, throat pain and sinus infections, those are the areas treated specifically by an ENT physician who specializes in treating diseases of the head and neck.
The treatments for GERD and LPR are fairly straightforward and, for the most part, non-invasive. The majority of people respond well to medication and lifestyle changes. Some of the most effective medications are over-the-counter, such as antacids. Other effective medications include proton pump inhibitors and foam barrier medications. Lifestyle changes include eating small meals slowly, reducing or stopping alcohol intake, and not eating or drinking within two or three hours of going to bed. Once you identify the foods that cause the most problems you can limit their intake and greatly reduce the problems associated with GERD and LPR. Common problem foods include caffeine, sodas, peppermint, and citrus fruits.
So How Is A Diagnosis Of Lpr Made
One must make an appointment with an ENT doctor for a complete throat and nose exam.
Dr. Koufman adds that there is now a special test called pharyngeal pH-monitoring that detects acid in the upper area of the throat.
If you have symptoms that seem to be GERD or sinusitis, dont try to self-diagnose make an appointment with an ENT physician.
Dr. Koufman has lectured nationally and internationally and is one of the worlds leading authorities on reflux. For 25+ years her pioneering research has focused upon acid reflux as it affects the voice and airway.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. Shes also a former ACE-certified personal trainer.
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The Diagnoses Of Allergy And Reflux Are Often Confused
For certain, all post-nasal drip is not allergy, and most self-diagnosing, self-treating patients falsely assume that their post-nasal drip is due to allergy when in fact they have silent respiratory reflux. Indeed, reflux is far more common than true allergy of the upper airway.
Many medications, including over-the-counter mucus-reducing medications, will improve the post-nasal drip of both allergy and reflux. However, in the case of reflux, the short-term improvement of post-nasal drip will not improve the underlying reflux condition. With reflux, patients can have nasal congestion and runny nose, but not usually sneezing or itchy eyes. The most common other symptoms associated with reflux are chronic throat-clearing, a sensation of a lump in the throat, hoarseness, and cough.
Many physicians are unaware of the clinical differences between allergy and reflux. Specifically, they are ignorant of the different physical findings, including the difference in the consistency of the mucus.
Are Heartburn And Acid Reflux Impacting Your Life
The heart has nothing to do with heartburn. Heartburn is mild to severe pain caused by digestive issues. While this issue is quite common and experienced by millions of Americans, that doesnt change how uncomfortable it is. Do you feel a sharp burning sensation behind your breastbone that moves upwards toward your neck and throat after eating? Does bending over or lying down only make you feel worse?
Heartburn is the main symptom of acid reflux and its chronic and more severe counterpart gastroesophageal reflux disease . Finding out what is causing your heartburn could be your first step toward relief. At Houston Sinus & Allergy, you can meet acid reflux and GERD doctors in Houston who can help you find treatment that works.
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Treatment Of Nasal Polyps
There is good news for patients with sinus polyps. In the past, the only option we had was surgical treatment which involved just removing the polyps and hoping they didn’t come back this was historically very ineffective and patients had frequent recurrences of their polyps. Now, due to technologies such as Propel, patients undergoing polyp surgery can have small absorbable devices placed in their sinus cavities that dissolve during the month following the surgery. These small devices contain steroids which dissolve into the sinus passages and help cut down on the recurrence.
The other advantage of these devices is that they have a spring type effect that keeps the sinuses open. That’s very important for post-operative care, because many patients need to use nasal steroids and saline rinses after their polyps are removed, but their sinuses often close down making the rinses ineffective. By keeping the sinuses open, thus allowing the medicines to get into the root of the sinuses, the results have improved dramatically for patients suffering from sinus polyps.
Sore Throat And Cough
The constant presence of mucus draining down your throat causes irritation. Your voice can be raspy and sore in a way thats different from a regular sore throat. In fact, your throat symptoms may not even start until the later stages of a cold for example, when youre otherwise feeling better but your nose is still draining. This is a very common complication of postnasal drip.
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How Do Laryngopharyngeal Reflux Symptoms Compare To Those Of Sinusitis
Dr. Koufman explains, Reflux can cause post-nasal drip and too much throat mucus, as can sinusitis but more importantly, reflux can actually be the cause of sinusitis.
LPR is called silent reflux because the reflux can occur during the night and when this occurs, the stomach contents actually make it all the way up into the back of the nose, where they can cause problems with the sinuses.
Description Of Controls And Cases Of Ar/nar/sinusitis As A Function Of Main Risk Factors
2887 subjects participated in the clinical visit and they had a mean age of 50.1 years. Cases of AR and sinusitis were younger than controls and cases of NAR . Controls and cases of NAR had a lower level of education and physical activity, a higher prevalence of obesity than cases of AR and sinusitis. Atopy, which was used to define NAR and AR, had a prevalence of 27% in controls and 58% in cases of sinusitis. Nasal polyps were rare in controls and cases of NAR, and more common in cases of AR and sinusitis. Use of antihistamines and steroids was frequent among cases of AR, and rare among cases of NAR, while the use of vasoconstrictors was similar in the two groups. Sex, smoking habits and alcohol intake did not significantly differ between cases and controls .
Table 1 Number and percent of controls, cases of non-allergic rhinitis , allergic rhinitis and sinusitis as a function of main socio-demographic, lifestyle, and clinical characteristics
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Do You Have Lpr: Reaching A Diagnosis
If you think you have LPR, get in touch with an ENT doctor or an otolaryngologist to investigate the nature of your symptoms. You may be recommended to take the following tests:
- Upper endoscopy: Although this procedure is known to diagnose GERD, it can also be helpful in diagnosing LPR. Instead of investigating the esophagus, the examiner can view the upper part of the throat and use physical manifestations of the condition along the throat. You can learn more in our previous post: A Complete Overview of Upper GI Endoscopy.
- pH test: Similar to an endoscopy, a pH monitoring test involves the insertion of a catheter down the nose to detect acid. This can help localize the damage from the reflux, which will determine if you have LPR or GERD.
What Is Silent Reflux
Acid reflux generally implies indigestion, say from eating spicy or acidic foods, or gastroesophageal reflux disease , a closely related yet chronic disorder with several causes. On the contrary, silent refluxofficially known as laryngopharyngeal reflux, or LPRisn’t characterized by the same symptoms of burning or stomach distress. Instead of the typical signs, silent reflux has its own symptoms.
Like regular acid reflux, silent reflux still occurs when stomach acid inadvertently flows up to the esophagus. This irritates your throat, causing the cough and post-nasal drip as well as hoarseness in the morning. It can also lead to a chronic need to clear your throat and the sensation that there’s a lump in your throatbecause as stomach acid irritates the esophagus, mucous membranes in the throat will produce more mucous than usual, explained Jamie Koufman, MD, director of the Voice Institute of New York and author of Dropping Acid: The Reflux Diet Cookbook & Cure.
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Can Sinus Drainage Make You Feel Like You Have Heartburn
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Can Acid Reflux Cause Sinus And Ear Problems
Chronic acid reflux or gastroesophageal reflux disease can produce symptoms beyond the usual heartburn and sore throat. GERD manifests itself in different ways, with some patients experiencing less common but still normal signs of the condition.
Can acid reflux lead to ear and sinus complications? Yes, it can. Although the reason for this is still indefinite, acid reflux can lead to ear and sinus infections for some patients.
On the other hand, patients experiencing postnasal drip, sore throat, and a swollen larynx may have laryngopharyngeal reflux or LPR, a similar stomach condition that is sometimes mistaken for GERD.
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Problems That Can Develop If You Have Postnasal Drip
You probably dont give nasal mucus a thought until its aggravated by a cold or allergies. Then, it can dominate your days until the underlying cause is over. While in most cases,postnasal drip is a temporary symptom that clears up with time, it can have complications, or it may be part of other rare health conditions that may not clear up naturally.
When postnasal drip becomes chronic, visitAlexis Furze, MD in Newport Beach. As an otolaryngologist and facial surgeon, Dr. Furze is uniquely qualified to diagnose and treat many of the conditions that cause post nasal drip and its complications.
Allergic Mucus Is Thin And Theres Usually A Lot Of It
Different medical conditions result in different consistency and color of the mucus. When people have inhalant allergies, e.g., dust, mold, pollen, the consistency of the mucus produced is usually copious, thin, and watery.
Many people with allergic rhinitis, for example, walk around carrying Kleenex and, when exposed to their inciting allergen, they usually have related symptoms such as stuffy nose, runny nose, sneezing, and itchy, watery, red or swollen eyes chronic throat-clearing is not typically a symptom of allergy.
Most people with allergic rhinitis have attacks when they come in contact with their offending allergens some people have more chronic symptoms, particularly those who are in constant contact with the offender however, many people who have constant allergic symptoms actually may have respiratory reflux. When patients with allergic rhinitis are examined by a knowledgeable physician, the usual findings are boggy, swollen, purplish nasal lining with a thin, clear-as-glass type of mucus.
People with allergic rhinitis can be successfully treated with antihistamine medications and steroid inhalers. That being said, the steroid inhalers must be used twice a day for an extended period of time before any benefit is realized. So its not relief immediately following a spray.
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