This unnoticed silent reflux caused the doctor to think I had sinus and/or asthma problems. The doctors didn't understand silent reflux, so the zoo began, with no coordination or overall perspetive, to the allergist, to the GI doctor (he didn't do a pH test, but did an endoscopy) to the pulmonary specialist to Catscans to ... anyway watch Mercola's video below, and get informed, because it looks like you may have to be the manager. (Going to an outside physician's assistant who is an expert in alternative health helped identify some of the wrong thinking, which in turn had me take over with more determination to direct the doctors.)
It was a major mistake to stop PPI (prilosec) cold, as it caused a huge rebound (had been directed by my GI doc!)
Get a good source of information before seeing your doctor.
The tips below helped me.
Read, links to outside sites:
CHECK FIRST
Have your doctor check for hiatal hernia or valve problems.
WATER, JUICE
Small drinks, drink lots, til urine is clear
Drinking a glass of lukewarm water or herbal tea after a meal can dilute and flush out stomach acid.
Very little or NO LIQUID should be consumed with other foods.
Aloe Vera juice. Aloe Vera is good for burns. Reflux is an acid burn. Drink a couple of ounces two or three times a day, to soothe and heal your throat and stomach.
HOW YOU EAT
And remember not to eat too quickly. Putting your fork or spoon down between bites can help you do this.
FREQUENCY/CONSTANCY
If you eat constantly (even sipping on a healthy smoothie) and/or drink coffee, your acid producing system will keep on working and might emit too much (sometimes just out of habit). Leave periods of two hours at a time, at least, where there is nothing other than water consumed.
SIZE OF MEALS
Eating large meals increases pressure in the stomach and against the LES muscle. Eating five or six small meals instead of three larger ones is better.
NO COLD ITEMS
Your stomach is temperature sensitive - when the temperature of the food is lower than body temperature everything will sit taking up space in the stomach until it all gets warmed up to body temp. That is, a dish of ice cream, a cold drink (even ice water) will stop your food from being digested.
FOODS
Bananas help to reduce the symptoms of GERD in two ways. First of all, they contain enzymes that stimulate the production of the mucus that covers the lining of the stomach. This healthy mucus helps to heal and prevent ulcers, the leading cause of acid reflux. Additionally, bananas are natural antacids, helping to reduce the over-production of stomach acids. Eating bananas as your dessert can help to decrease after-meal heartburn.
A can of live-culture yogurt each week or more often, or daily acidophilous. Good: chewable acidophilus
Fiber aids in elimination and functions as a bulking agent in the stomach. Fiber works as a natural antacid as it binds to the acids in the stomach, preventing them from splashing up and burning the esophagus. The best sources of fiber are whole grains and raw vegetables.
Veggie burgers are good.
Graham crackers. They soak up liquids in the stomach, can help calm things. One or two is a snack, a box is a problem
Ok
Pop corn, very low fat or air-popped
Avoid:
High-fat foods as well as refined flours and sugars are some of the biggest culprits
High-fat foods tend to stay in the stomach longer.
Spicy foods are known to cause heartburn symptoms in many GERD patients.
Stimulants include alcohol, tobacco, stress and anti-inflammatory medications.
caffeine.
Avoid acidic food - Citrus and tomato based. chocolate, onions, garlic, and peppermint
cheeses, and eggs.
Proteins and carbohydrates when combined together, can be difficult to digest (for some people).
Because of this, they will sometimes sit in the stomach for long periods of time and dramatically increase the chance of having acid reflux, indigestion, bloating and even constipation
Limit. Aspirin
DIGESTIVE ENZYMES
Work with your doctor on this, but digestive enzymes can sometimes be quite helpful.
WEIGHT, POSTURE
Lose weight.
Align the esophagus, the diaphragm, and the stomach to reduce the likelihood of reflux. (Don't slouch, bend over. Open up the body by moving arms overhead in an arch.)
SLEEPING, LYING DOWN
Elevate head of bed 4-8 inches (raise bed on blocks or wedge under the head of the mattress (5" risers for the bed are available at Bed, Bath, and Beyond)
Mattress Genie can be blown up to raise the top mattress, but a board or
something solid is needed to keep the mattess from folding in the middle.
Avoid lying down for 3 to 4 hours after eating
ANTACID THERAPY
Update: see Dr. Mercola video/article at top of this page, as it will give you perspective and understanding as to being careful and more skillful on how you use the information below.
Keep antacids handy. At every episode take four -- one every one to two minutes
Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids, Riopan, and Tums are the first drugs recommended to relieve heartburn and other mild GERD symptoms. These are over-the-counter medications. They use combinations of three basic salts--magnesium, calcium, and aluminum--with hydroxide or bicarbonate ions to neutralize stomach acids. There are side effects of these medicines. Magnesium containing preparations can cause diarrhea; aluminum salts can cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects. Calcium containing antacids can also be a supplemental source of calcium but they can also cause constipation.
Foaming agents, such as Gaviscon, work by covering your stomach contents with foam to prevent reflux. These drugs may help those who have no damage to the esophagus.
H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), impede acid production. They are available in prescription strength and over the counter. These drugs provide short-term relief, but over-the-counter H2 blockers should not be used for more than a few weeks at a time. They are effective for about half of those who have GERD symptoms. Many people benefit from taking H2 blockers at bedtime in combination with a proton pump inhibitor.
Proton pump inhibitors
These include omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium), which are all available by prescription. Proton pump inhibitors are more
THROAT, SINUS
Acid reflux can cause not only a sore throat but other ear, nose and throat disorders
The esophagus, however, is not made to handle your stomach acids and when this backup occurs your body sends out alarm signals in order to minimize the damage. These alarm signals cause the body to do certain things in order to protect itself and one of the things is to produce extra mucus. The mucus will take away the caustic nature of the asset and neutralize the damage as well as stop the acid from spreading further up the esophagus. The funny thing is that sometimes when this is happening it actually stops the heartburn symptoms so you might not even know you're having acid reflux!
This constant backwash of acid can irritate the lining of your esophagus, causing it to become inflamed (esophagitis). Over time, the inflammation can erode the esophagus, causing complications such as bleeding or breathing problems.
Hoarseness, lump-in-the-throat sensation, chronic cough and throat clearing, and mucus build-up in the throat
Sometimes, the symptoms of GERD can mimic some of the symptoms of sinusitis. The sensation of post-nasal drainage and the need to clear your throat constantly may be due to post-nasal drainage -- but may also be due to GERD. The sinus specialist may therefore examine you in the office to see if there is physical evidence of GERD.
Acid reflux can sometimes actually contribute to sinusitis! That is to say, the acid can travel all the way up to your nose and sinuses (for instance, while you are lying down asleep), and this acid can inflame the nose and sinus linings.
Do a fiberoptic evaluation of your nose and sinuses to pinpoint the problem,
Patients with asthma typically complain of some combination of coughing, wheezing, chest tightness, dyspnea (difficult or painful breathing), and increased mucous production. Typically these signs and symptoms of airway obstruction are reversible. Patients can experience asthma on a wide ranging continuum. For some, asthma "attacks" are infrequent and mild. For others, symptoms can seem continuous and may land patients in and out of the hospital on a regular basis.
Wheezing is perhaps the most "specific" symptom of an adult patient in the general population with asthma. This means that most adult patients who wheeze have asthma. Dyspnea, or shortness of breath, is often described as chest-tightness or a breathless sensation. Ironically, it is very difficult to correlate a patient's subjective sensation of shortness of breath with an objective measurement of airway obstruction. What seems to impact this sensation most is the percentage change in a patient's airway function rather than the absolute value of lung function.
Patients suspected of having asthma should have a thorough evaluation by a pulmonologist (lung specialist). In addition to taking a thorough history and performing a complete physical examination, pulmonologists have many adjunctive tools at their disposal for the diagnosis of asthma. Pulmonary function testing is an invaluable tool in the characterization of a patient's lung function. While several methods exist for evaluating pulmonary function, spirometry is one of the most widely available. With simple inhalation and exhalation into a hand-held device, measurements can be obtained which characterize a patient's lung function in detail.
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. Endoscopy is sometimes performed to evaluate the esophagus for damage from acid burns and to examine the stomach for irritation and ulceration. Your doctor will perform an endoscopy to pass a tube with a camera down your throat to look for evidence in the throat and stomach of a hiatal hernia (the sphincter doesn't keep food in your stomach) and reflux damage. Note that this may or may not be a pleasant experience but can be a lifesaver. See, the stomach acids over time will damage the throat. It can cause sections of the esophagus to constrict or partially close off -- causing choke, or inability to swallow for periods of time.
Medical treatment is based on neutralizing stomach acid, reducing or eliminating stomach acid and improving gastric emptying. Neutralizing stomach acid can be achieved by using over-the-counter antacids in liquid or tablet form such as Sucralfate suspension, Maalox, and Ryopan. Reducing or eliminating stomach acids can be achieved with H-2 blockers, which are drugs that depress acid production, such as Cimetadine (Tagamet), Ranitidine (Zantac), or Famotidine (Pepcid). These are also now available over-the-counter at lower dosage. Antacids and H-2 blockers should be taken one hour apart as antacids may reduce the other drugs' effectiveness. New drugs like Omeprazole (Prilosec) and Nexium completely stop stomach acid production. These drugs are generally prescribed for short-term use - and appear to be harmful long term!
