Gastroesophageal reflux disease (GERD) is the main etiologic factor of erosive esophagitis (“reflux esophagitis”). The prevalence of esophagitis is less than 10% in the general population, and approximately 30% in patients with gastroesophageal reflux symptoms.
Acid reflux creates a burning pain in the lower chest area, often after eating. Exact figures vary, but diseases resulting from acid reflux are the most common gut complaint seen by hospital departments in the United States.
Q. Several years ago I started having severe chest pains that seemed to be stress related. I went to a cardiologist, who checked me out completely and said I didn’t have any heart problems.
Comparable with our study, Fuji- wara and colleagues indicated more symptoms of GERD with higher level of physical activity. 28,34 Higher BMI has been associated with GERD in our study like many other surveys . The patients usually suffer from troublesome symptoms, namely heart burn, regurgitation, and many extra-esophageal complaints. The prevalence of GERD varies in different areas of the world and even in different parts inside a country.
We see patients with laryngopharyngeal reflux all the time. The train started back in the early ’90s in Winston-Salem when Don Castell and Joe Richter were working with James Koufman, and they put together some very interesting work on the relationship between gastroesophageal reflux and extraesophageal disease. Lo and behold, the larynx was part of this focus, and Dr. Koufman really took off on this and started to educate laryngologists that this can occur. Visit our Acid Reflux / GERD category page for the latest news on this subject, or sign up to our newsletter to receive the latest updates on Acid Reflux / GERD. The main treatment options for people who repeatedly experience acid reflux in GERD are either PPIs or H2 blockers, both of which are medications.
1 Castell in 1985 described GERD and pressed it as an “iceberg”, 2 thereafter the apparent part of the “iceberg” has been growing con- tinually. Extra-esophageal symptoms may be a consequence of GERD but there is substantial overlap with other etiologies. Patients with documented GERD and prominent symptoms such as chest pain, cough, hoarseness or wheezing do not always realize any benefits in these extra-esophageal symptoms after antireflux surgery.
Patients with this disease tend to be younger than those with endoscopy-positive disease and are more likely to be female, thin and without hiatal hernia. The trials have shown that, in patients with endoscopy-negative reflux disease, symptoms (particularly heartburn) tend to be less severe and less frequent than in patients with endoscopy-positive disease. The overlap between the groups is such, however, that the symptoms cannot be used to distinguish reflux patients with oesophagitis from those without. Approximately 50% of patients with endoscopy-negative disease were found to have levels of oesophageal acid exposure that fell within the normal range. Oesophageal pH monitoring is therefore of limited value in patients with endoscopy-negative reflux disease, unless the test focuses on analysis of the correlation between symptoms and episodes of reflux.
Laryngopharyngeal reflux is a condition in which acid that is made in the stomach travels up the esophagus (swallowing tube) and gets to the throat. Ginger is widely known for its anti-inflammatory properties, an essential quality for reducing inflammation from low stomach acid.
- A retrospective case-control study in China in 2010 found that a high waist-hip ratio, hyperglycemia, hypertriglyceridemia, and MetS were the associated factors for RE, and that HDL-C was associated with a reduced risk of RE in men .
- Refractory esophagitis may be related to poor adherence to therapy and/or insufficient acid secretion inhibition and represents a potential indication for anti-reflux surgery (laparoscopic fundoplication) which provides excellent functional results, but may have side effects.
- Ginger is widely known for its anti-inflammatory properties, an essential quality for reducing inflammation from low stomach acid.
- The overlap between the groups is such, however, that the symptoms cannot be used to distinguish reflux patients with oesophagitis from those without.
So, my plea to you is to take a good voice history, listen to the patient, look for habituation, develop a relationship with a speech-therapy rehabilitation clinician or a laryngologist who has a vested interest in voice. These patients will need speech rehabilitation, and the habits will go away with time. Prescribe PPI therapy if you are going to study these patients. You don’t want to study them and find that they have reflux, and then they say, “Now what do we do?” I study them on therapy and look for events that I can mark as a symptom event. You almost never find that.
The incidence of ulcers of the stomach and duodenum and their response to medical therapy, in patients with Zollinger-Ellison syndrome is well described. However, reflux esophagitis is less well recognized. In this study we determined the frequency of reflux esophagitis in 122 patients with Zollinger-Ellison syndrome and examined their response to medical therapy. Esophageal symptoms, endoscopic abnormalities, or both were present in 61% of patients. Forty-five percent of patients had esophageal symptoms consisting of heartburn, dysphagia, or both.
Furthermore, we don’t have a validated instrument to define GERD in patients with laryngopharyngeal reflux. A variety of findings in the larynx can be nonspecific, such as erythema, edema, swelling, and cobblestoning. These findings can be induced by other conditions, such as postnasal drip, allergies, asthma, voice abuse, and even by repetitive behaviors such as throat clearing.
New studies have also made clear, for the first time, that endoscopy-negative acid reflux disease has a measurable and substantial impact on the patients’ general well-being and quality of life. Patients with endoscopy-negative disease have quality-of-life scores that are similar to those found in patients with oesophagitis.
The other 33% of patients required an increase in medication to lower acid output to less than 5 mEq/h in 7% and less than 1 mEq/h in the other 26% to resolve symptoms and signs completely. We conclude that reflux esophagitis occurs in the majority of patients with Zollinger-Ellison syndrome and responds well to medical therapy, although one third of patients require intensive antisecretory medication. Gastroesophageal reflux disease (GERD) is the long-term, regular occurrence of acid reflux.
Patients may too often be directed to increasing medical therapies or even redo antireflux procedures rather than revisiting the differential diagnosis from a broader perspective. Efficacy (healing, symptom relief) and cost-effectiveness are the principal reasons for the rapidly increasing use of proton pump inhibitors (PPIs) for the management of gastro-oesophageal reflux disease. The charts of 19 patients with a ringed esophagus were reviewed. A single pathologist interpreted all available esophageal biopsy specimens and graded them for the presence of GERD-related abnormalities. Phone interviews were conducted to assess response to therapy and confirm historical features obtained from medical records.
This can cause heartburn and tissue damage, among other symptoms. Smoking and obesity increase a person’s risk of GERD. It is treatable with medication, but some people may need surgery. In this article, learn more about GERD. The “ringed” or “corrugated” esophagus is a cause of chronic dysphagia and recurrent food impactions in young men.