Correlation between Allergic Laryngopharyngeal and Rhinitis Reflux

A primary care physician often encounters patients with extra esophageal manifestations of GERD in the absence of heartburn. Patients might present with symptoms involving the pulmonary system; noncardiac chest pain; and ear, . throat and nose disorders. Local irritation in the esophagus can cause symptoms that vary from indigestion, like chest discomfort and abdominal pain, to coughing and wheezing. If the gastric acid reaches the relative back of the throat, it may cause a bitter taste in the mouth and/or aspiration of the gastric acid into the lungs.

All patients completed the SFAR questionnaire for allergic rhinitis, and the ratings ranged between 0 and 16 with a mean score of 8 ± 4.24. Based on the SFAR scoring system there were 84 patients with positive AR diagnosis while 42 patients were with negative AR diagnosis. Among the positive AR patients, 54 were in the positive LPR representing 85% of total group number. On the other hand there were 30 patients with positive AR diagnosis in the negative LPR group representing 48% of the total group number (Table 2).

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Chronic cough is a multifactorial symptom that requires multidisciplinary approach. Over the last years, general practitioners refer increasingly more chronic cough patients directly to the otolaryngologist. The aim of this paper is to highlight the issues in diagnosis and management of chronic cough patients from the otolaryngologist perspective.

Ask about postnasal allergies and drip. Listen to these people when they describe their symptoms, and that might give the diagnosis right there in the office away. We see patients with laryngopharyngeal reflux all the time.

GERD affects one third of the adult population to some degree nearly, once a month at least. Almost 10% of adults experience GERD weekly or daily.

Only approximately 20% of acid reflux sufferers get heartburn, the symptom most associated with the condition. Eighty percent (80%) experience respiratory symptoms, such as sinus issues, chronic cough, post-nasal drip and thick mucus in the throat. With those statistics, it’s no wonder its misdiagnosis is so prevalent. If acid reflux disease (GERD) is the cause of your chronic rhinitis and post-nasal drip, you may see a gastroenterologist, a specialist in conditions of the digestive tract.

We don’t send patients to surgery just to see if they will get better. We know that antireflux surgery has considerable risk, and it is not done very often anymore. The non-PPI responder is the worst patient to send to an antireflux surgeon. Once we get out of a “restful voice,” the inflammation in the laryngeal area increases. When these patients come in and are already on proton pump inhibitor (PPI) therapy but are not responding, it’s important to take a good voice history.

When treating post-nasal drip at home you may need to vary your treatment slightly depending on whether the secretions are thick or thin. Try the tips below based upon the cause of your symptoms.

LPR is similar to Gastroesophageal Reflux Disease, or GERD. It occurs when the lower esophageal sphincter (LED) does not close properly and the stomach contents are allowed to leak back or reflux into the esophagus and then up to the voice box and possibly the back of the nose and sinus cavity. When the refluxed stomach acid comes into contact with the lining of the esophagus, it causes a burning sensation in the chest or in the throat that we call heartburn or acid indigestion.

We still agree that this can occur, but the train has accelerated to the fast track. Of new patient referrals to otolaryngologists, 1 in 10 receives a diagnosis of laryngopharyngeal reflux disease. It is believed that anything that refluxes into the larynx is attributable to gastroesophageal reflux disease (GERD), but that’s not the case. Certainly when patients are referred to us for a reddened larynx (having been told “you have GERD; go see your gastroenterologist and he or she will make you better”), they come to us, the final end of the road, and we are supposed to cure them. Sinusitis occurs when bacteria or viruses infect the sinus cavities, usually due to blockage of the small drainage pathways that lead to the nasal passages.

A gastroenterologist might decide to order some additional tests to evaluate your GERD. A Barium swallow is a series of x-ray films that monitor dye as it travels through the stomach. A PH monitoring test is a 24-hour test to record the back flow of acid from the stomach into the esophagus and even the throat. A small flexible tube is placed in the stomach through the nose and is connected to a small computer to record 24-hour acid reflux.

The nagging problem, says Koufman, is that most people associate acid reflux with heartburn, when they are much more likely to have respiratory symptoms that mimic the common cold, flu, or allergies. Acid reflux is an uncomfortable condition in which stomach acid flows back into the food pipe. This article investigates which drinks shall make it worse, and what you should drink to minimize symptoms.

Millions of people believe they are suffering from a allergies or virus, but they may very well be wrong. A top expert contends their problem is a type of acid reflux. The disease can also result in scarring of the voice box and windpipe, the total results of a faulty lower esophageal sphincter, the muscle that separates the esophagus from the stomach. “Compared to the esophagus, the throat and voice box are a hundred times more sensitive to irritation from this reflux,” says Koufman, who is also a clinical professor of otorhinolaryngology at the New York Eye & Ear Infirmary at Mt. Sinai in New York City. What’s confusing is are two types of reflux there; gastroesophageal reflux disease, or GERD, and “atypical,” or “silent” reflux, which is called “laryngopharyngeal,” reflux, an accepted condition for which Koufman, a pioneer in the field, coined the term.

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