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Chronic sore throats- a case of GERD .. Acid Refluxing

GERD is Gastro Esophgeal Reflux Disorder....

When the gastric secretion is more than what can be handled by the stomach or can be neutralised by the food we eat, it tends to overflow into the foodpipe (Esophagus). When this happens, various symptoms may be felt- heart burn, burning sensation in the throat, sour taste in the mouth or bitter, foul breath , sensitivity of teeth and even tooth decay.

Some people also feel bloated and as if something is stuck in their throat.

Though simple antacids will work fine to control the 'acid excess' part of the syndrome, (Syndrome is a combination of features we would expect in a given condition), these do not prevent the overflow (Reflux) part. For that you would need a medication that can control or modify the muscle tone of the food pipe, the stomach and the valve between the two.

So if you just feel that you have pain in the area between the chest and the abdomen, what we, in medical language call epigastrium, a simple anti acidic medicine or even cold milk will be of help. But if you begin to feel your symptoms in the throat, you need more... something to keep the acid down.

The agents like Omeprazole have been the gold standard to control acidin the stomach. In the earlier days it used to be done with Zinetec. Then came Famotidine. These are different classes of medicines that decrease the acid levels in the stomach.

Then came even newer agents- Lanzoprazole, Pantoprazole etc.

Now, in the initial stages, we would treat a patient with a combination of an anti acid agent like Omeprazole and a mobility regulator to prevent reflux like Itopride or Domperidone etc.

It has also been seen that patients who do not respond to standard treatment have some bacteria living within the lining of the stomach. These produce more and more acid. And survive in acidic environment that they create. So, these bacteria need to be treated separately WITH the anti-acid treatment. We would ordinarily use a Kit- Clarithromycin and Omeprazole, together, both the tablets to be taken about half hour before meals for about 15 to 20 days. Thereafter, we would put the patient on simple Omeprazole or Omeprazole Domperidome combination.

Some life-style changes help to keep both the acid and the reflux down.

Eat something bland every three to four hours. Do not go empty stomach for long periods.

The purpose of the acid is to digest the food. When the food is not there, the acid cannot be neutralised.

Donot lie down immediately after eating. This loosens the sphincter between the stomach and the food pipe. It is preferrable to move around a bit- a walk at night is ideal before bed.

It helps to do Vajra Aasana after meals... the ONLY Yoga aasana recommended after meals. This is good for digestion and neutralisation of acid.

In some other cases when it still does not work satisfactorily (very rare) we would recommend raising the head end of the bed a few inches- a few bricks under the feet of the bed not just more pillows. If you need any more information, let me know!

It is interesting to note that spicy food often is not the reason for increased acidity. It is usually a Type A personality, compulsive and workaholic, perfectionist. The spices CAN and DO aggravate the problem but do not cause it!

Please not: This piece is only educational. You must consult your ENT Doctor and follow only prescribed mecication and therapy.