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Certified by the
American Board of Otolaryngology.
Specializing in Ear, Nose,
and Throat Medicine and Surgery, Allergy, Hearing Aids, And
Hearing Tests. |
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Reflux esophagitis and
laryngitis are caused by leakage of stomach juices out of
the stomach and into the esophagus and throat. The juice
from the stomach is highly acidic and contains digestive
enzymes. These have the same effect on delicate throat
linings as they do on the food we eat. Irritation, a bitter
taste, coughing, soreness, throat clearing, and excessive
mucus are all symptoms associated with this disorder.
A sensation of a lump in the
throat due to spasm of the muscle at the top of the
esophagus is also a common symptom.
The following instructions
are intended to help decrease the acidity of the stomach
juices, reduce the production of acid, and prevent leakage
of the stomach juices out of the stomach. When the symptoms
are severe, strict attention must be paid to the following
instructions.
When symptoms are less
severe, you may use your judgment as to which suggestions
should be followed. It is common for resolution of symptoms
to require two to four weeks for significant improvement to
be noted. Refer back to this page if symptoms recur in the
future.
- Take an antacid in
liquid form (Maalox, Mylanta, or other antacid of your
choice) 30 minutes after meals and at bedtime. The usual
dose is 30 ccs. A double dose at bedtime is frequently
helpful. If symptoms are not improved within one week,
please contact us. You will probably require a
medication, such as Zantac or Propulsid.
- If you are overweight,
you should begin a weight loss program.
- Diet restrictions help
control symptoms. A bland diet divided into multiple
small feedings is recommended. What is bland for one
person may be too spicy for another. Use common sense
and restrict obviously irritating foods. Five or six
snacks per day are desirable rather than three full
meals. Food should be properly chewed and should not be
too hot or too cold. Take your time while eating.
- Alcohol, tobacco,
caffeine and chocolate are agents which dilate the lower
esophageal sphincter and allow leakage from the stomach
into the esophagus. These are to be strictly avoided
during times when symptoms are present. Alcohol and
caffeine also stimulate stomach acid secretion. Candy,
lozenges, gum and breath fresheners taken between meals
are to be avoided. The stomach can be fooled into
thinking that a meal is about to be presented and will
ready stomach acid in preparation for receiving food.
Between-meal snacks are preferable.
- Do not eat for four
hours before retiring to bed. Go to bed on a completely
empty stomach, except for liquid antacid and evening
medications.
- The head of your bed
should be elevated such that the throat is higher than
the stomach. Most of the damage done by reflux of
stomach acid occurs at night. If you have a regular bed,
put the legs of the head of the bed on eight inch blocks
and sleep on three pillows, such that you are flexed at
the waist. If you have another type of bed, multiple
pillows will be necessary to achieve desired height. If
your symptoms are quite severe, sleeping in a reclining
lounge chair is often necessary.
- Clothing that fits
tightly across the mid-section of the body should be
avoided. Women should not wear constricting garments
such as girdles. Men should wear suspenders rather than
a belt. Braces that constrict the stomach should be
avoided during the treatment for reflux esophagitis.
- Practice abdominal
breathing during the time you are symptomatic.
Concentrate on pushing out the stomach with each breath,
instead of expanding the chest. Allow your stomach to be
relaxed. A tense abdominal wall increases
intra-abdominal pressure and increases the likelihood
that stomach acid will be pushed out of the stomach and
upwards into the esophagus.
- Do not bend or stoop
anymore than is absolutely necessary. Gardening or
chores on the hands and knees should be avoided.
Exercises requiring lifting or bending should also be
avoided during the treatment period.
- Stress stimulates
secretion of stomach acid. If your life is stressful,
and our treatment is initially not successful, it may be
necessary to enter treatment for stress reduction and/or
for uncontrolled anxiety.
Please contact us if this
is a problem that needs attention.
If at any time your symptoms are getting worse or new
symptoms that do not fit this pattern appear, you should let
us know about it. Although reflux esophagitis and laryngitis
are common symptoms, they are by no means the only reason
for a sore throat or a feeling of a lump in the throat.
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