Reflux Laryngitis (cont.)
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
In this Article
- Why does reflux laryngitis occur?
- What are the typical symptoms of reflux laryngitis?
- How are reflux laryngitis evaluated?
- What is the conservative therapy of reflux?
- What types of medications are used to treat reflux?
- What are the difficulties in diagnosing reflux laryngitis?
- Reflux Laryngitis At A Glance
- Find a local Gastroenterologist in your town
What are the typical symptoms of reflux laryngitis?
Heartburn is the most common symptom associated with reflux. Approximately 50% of the U.S. population experiences heartburn at least monthly, and 4%-7% experience it daily. In addition to heartburn, reflux severe enough to cause laryngitis can cause chronic hoarseness, asthma, or a foreign body sensation in the throat (globus phenomenon).
How is reflux laryngitis evaluated?
In most patients, the presumptive diagnosis of reflux laryngitis is based on the typical history of heartburn and hoarseness. Testing usually is reserved for those patients who do not respond to conservative therapy (as explained below) or drug therapy. Diagnostic tests includes an:
What is the conservative therapy of reflux?
The treatment of reflux laryngitis is the treatment of gastroesophageal reflux.
- Antacids neutralize stomach acid and give immediate
relief. Popular choices include sodium bicarbonate (Alka Seltzer),
carbonate (Tums, Rolaids, Alka-Mints), and
aluminum and magnesium antacids
(Maalox, Mylanta, Riopan, Gaviscon). It is best to use antacids 30 to 60 minutes
after each meal and at bedtime because they are more effective at these times.
If patients are on a low sodium diet, they should avoid sodium bicarbonate.
Calcium and aluminum can cause constipation, while magnesium antacids can cause
diarrhea. Patents with
kidney disease should avoid magnesium and aluminum antacids. Patients
should check with their pharmacist or doctor for any interactions with other
medications they are taking.
- Large meals for dinner should be avoided.
- Several hours should be allowed after eating before lying down to allow
the stomach to empty. Eating after the evening meal and bedtime snacks should be
- Spicy or fried foods, peppermint, citrus, tomatoes, onions, and chocolate,
especially if these foods increase symptoms, should be avoided.
- The diet should be high-protein, high-carbohydrate, and low-fat.
- It may be helpful to elevate the head of the bed with
wooden blocks under the bedposts to allow gravity to keep the acid in the
stomach. Pillows under the head are of negligible benefit though wedges that
elevate the head and upper chest are effective.
- Alcohol, caffeinated beverages, and tobacco should be avoided.
- Losing weight reduces reflux.
- Drugs such as nonsteroidal antiinflammatory drugs (NSAIDS), theophylline (Theo-Dur, Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin), anticholinergics, and calcium channel blockers should be avoided if feasible, but discontinuing any medication should be discussed with the doctor first.
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