Reflux Laryngitis (cont.)

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).

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:

• esophagram,
  
  
• endoscopy,
  
  
• laryngoscopy,
  
  
• esophageal pH monitoring, and
  
  
• esophageal motility studies.

The treatment of reflux laryngitis is the treatment of gastroesophageal reflux.

1. Antacids neutralize stomach acid and give immediate relief. Popular choices include sodium bicarbonate (Alka Seltzer), calcium 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.
   
   
2. Large meals for dinner should be avoided.
   
   
3. 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 avoided.
   
   
4. Spicy or fried foods, peppermint, citrus, tomatoes, onions, and chocolate, especially if these foods increase symptoms, should be avoided.
   
   
5. The diet should be high-protein, high-carbohydrate, and low-fat.
   
   
6. 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.
   
   
7. Alcohol, caffeinated beverages, and tobacco should be avoided.
   
   
8. Losing weight reduces reflux.
   
   
9. 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.

Source: MedicineNet.com
http://www.medicinenet.com/reflux_laryngitis/article.htm