Our team of specialists and staff believe that informed patients are better equipped to make decisions regarding their health and well being. For your personal use, we have created an extensive patient library covering an array of educational topics. Browse through these diagnoses and treatments to learn more about topics of interest to you. Or, for a more comprehensive search of our entire Web site, enter your term(s) in the search bar provided.
As always, you can contact our office to answer any questions or concerns.
Our Library at a quick glance:
Ears
- Children and Facial Paralysis
- Child's Hearing Loss
- Cholesteatoma
- Cochlear Implants
- Dizziness and Motion Sickness
- Fall Prevention
- Ear Plastic Surgery
- Ear Tubes
- Earaches
- Ears and Altitude
- Earwax
- Quick Glossary for Good Ear Health
- Autoimmune Inner Ear Disease
- Better Ear Health
- Buying a Hearing Aid
- Child Screening
- Chronic Otitis Media
- Cochlear-Meningitis Vaccination
- Day Care and Ear, Nose, and Throat Problems
- Ear Infection and Vaccines
- Your Genes and Hearing Loss
- How the Ear Works
- Hyperacusis
- Know the Power of Sound
- Noise-Induced Hearing Loss In Children
- Pediatric Obesity
- What You Should Know About Otosclerosis
- When Your Child Has Tinnitus
- Why Do Children Have Earaches?
- Infant Hearing Loss
- Noise and Hearing Protection
- Perforated Eardrum
- Swimmer's Ear
- Tinnitus (also, heres a link to a very good tinnitus organization ATA)
- TMJ
Throat
- About Your Voice
- Common Problems That Can Affect Your Voice
- Day Care and Ear, Nose, and Throat
- Effects of Medications on Voice
- Gastroesphageal Reflux (GERD)
- How Allergies Affect your Child's Ears, Nose, and Throat
- Laryngeal (Voice Box) Cancer
- Laryngopharyngeal Reflux and Children
- Nodules, Polyps, and Cysts
- Pediatric GERD
- Pediatric Obesity and Ear, Nose, and Throat Disorders
- Special Care for Occupational and Professional Voice Users
- Tips for Healthy Voices
- Tonsils and Adenoids
- Tonsillectomy Procedures
- Tonsillitis
- Tonsils and Adenoids PostOp
- Vocal Cord Paralysis
- GERD and LPR
- Hoarseness
- How the Voice Works
- Secondhand Smoke
- Sore Throats
- Swallowing Disorders
Nose and Mouth
- Allergies and Hay Fever
- Antihistamines, Decongestants, and "Cold" Remedies
- Continuous Positive Airway Pressure (CPAP)
- Facial Sports Injuries
- 20 Questions about Your Sinuses
- Allergic Rhinitis (Hay Fever)
- Allergic Rhinitis, Sinusitis, and Rhinosinusitis
- Antibiotics and Sinusitis
- Are We Through With Chew Yet?
- Could My Child Have Sleep Apnea?
- Day Care and Ear, Nose, and Throat Problems
- Deviated Septum
- Do I Have Sinusitis?
- How Allergies Affect your Child's Ears, Nose, and Throat
- Pediatric Obesity
- Sinus Headaches
- Sinus Pain
- Sinus Surgery
- Sinusitis: Special Considerations for Aging Patients
- Tips for Sinus Sufferers
- Tongue-tie (Ankyloglossia)
- Your Nose: The Guardian Of Your Lungs
- Fungal Sinusitis
- Mouth Sores
- Nasal Fractures
- Nose Surgery
- Nosebleeds
- Post-Nasal Drip
- Salivary Glands
- Secondhand Smoke
- Sinusitis
- Smell and Taste
- Smokeless Tobacco
- Snoring
- Stuffy Noses
- TMJ Pain
Head and Neck
- Facial Plastic Surgery
- Facial Sports Injuries
- Children and Facial Trauma
- Pediatric Head and Neck Tumors
- Head and Neck Cancer
- Thyroid Nodules
- Laryngeal (Voice Box) Cancer
- Pediatric Thyroid Cancer
- Rhabdomyosarcoma
- Smokeless Tobacco
- Are We Through With Chew Yet?
- Quiting Smokeless Tobacco
- Secondhand Smoke
- Skin Cancer
Pediatric
- Child Screening
- Children and Facial Trauma
- Could My Child Have Sleep Apnea?
- Day Care and Ear, Nose, and Throat
- How Allergies Affect your Child's Ears, Nose, and Throat
- Pediatric Food Allergies
- Pediatric Obesity and Ear, Nose, and Throat Disorders
- Pediatric Sinusitis
- Secondhand Smoke and Children
- Tonsillitis
- Tonsillectomy Procedures
- Tonsils and Adenoids PostOp
- Ear Tubes
Espanol
- Colesteatoma
- Diábolos Estudio acerca de causas y opciones terapéuticas
- Doctor? ¿Por Qué a Mi Hijo Le Duele El OÃdo?
- Doctor? ¿Qué Causa El Ruido En El OÃdo?
- El Humo del Tabaco Ambiental y los Niños
- La pérdida de la audición
- Otitis Media Crónica (Infección del OÃdo Medio) e Hipocusia
- Perfóracion Timpánica
- Qué Debe Saber Acerca de la Otoesclerosis
- Screening de Audición en Niños
- Sirvan Las Amigdalas Y Los Adenoides?
Insight into the diagnosis, prevention, and treatment
- What are the symptoms of GERD and LPR?
- Who gets GERD or LPR?
- How are GERD and LPR diagnosed and treated?
- and more...
What is GERD?
Gastroesophageal reflux disease, often referred to as GERD, occurs when acid from the stomach backs up into the esophagus. Normally, food travels from the mouth, down through the esophagus and into the stomach. A ring of muscle at the bottom of the esophagus, the lower esophageal sphincter (LES), contracts to keep the acidic contents of the stomach from “refluxing” or coming back up into the esophagus. In those who have GERD, the LES does not close properly, allowing acid and other contents of the digestive tract to move up–to “reflux”–the esophagus.
When stomach acid touches the sensitive tissue lining the esophagus and throat, it causes a reaction similar to squirting lemon juice in your eye. This is why GERD is often characterized by the burning sensation known as heartburn.
In some cases, reflux can be silent, with no heartburn or other symptoms until a problem arises. Almost all individuals have experienced reflux (GER), but the disease (GERD) occurs when reflux happens often over a long period of time.
What is LPR?
During gastroesophageal reflux, the contents of the stomach and upper digestive tract may reflux all the way up the esophagus, beyond the upper esophageal sphincter (a ring of muscle at the top of the esophagus), and into the back of the throat and possibly the back of the nasal airway. This is known as laryngopharyngeal reflux (LPR), which can affect anyone. Adults with LPR often complain that the back of their throat has a bitter taste, a sensation of burning, or something “stuck.” Some patients have hoarseness, difficulty swallowing, throat clearing, and difficulty with the sensation of drainage from the back of the nose (“postnasal drip”). Some may have difficulty breathing if the voice box is affected. Many patients with LPR do not experience heartburn.
In infants and children, LPR may cause breathing problems such as: cough, hoarseness, stridor (noisy breathing), croup, asthma, sleep-disordered breathing, feeding difficulty (spitting up), turning blue (cyanosis), aspiration, pauses in breathing (apnea), apparent life-threatening event (ALTE), and even a severe deficiency in growth. Proper treatment of LPR, especially in children, is critical.
What are the symptoms of GERD and LPR?
The symptoms of GERD may include persistent heartburn, acid regurgitation, nausea, hoarseness in the morning, or trouble swallowing. Some people have GERD without heartburn. Instead, they experience pain in the chest that can be severe enough to mimic the pain of a heart attack. GERD can also cause a dry cough and bad breath. (Symtoms of LPR were outlined in the last section.)
While GERD and LPR may occur together, patients can also have GERD alone (without LPR) or LPR alone (without GERD). If you experience any symptoms on a regular basis (twice a week or more), then you may have GERD or LPR. For proper diagnosis and treatment, you should be evaluated by your primary care doctor or an otolaryngologist—head and neck surgeon (ENT doctor).
Who gets GERD or LPR?
Women, men, infants, and children can all have GERD or LPR. These disorders may result from physical causes or lifestyle factors. Physical causes can include a malfunctioning or abnormal lower esophageal sphincter muscle (LES), hiatal hernia, abnormal esophageal contractions, and slow emptying of the stomach. Lifestyle factors include diet (chocolate, citrus, fatty foods, spices), destructive habits (overeating, alcohol and tobacco abuse) and even pregnancy. Young children experience GERD and LPR due to the developmental immaturity of both the upper and lower esophageal sphincters. It should also be noted that some patients are just more susceptible to injury from reflux than others. A given amount of refluxed material in one patient may cause very different symptoms in other patients.
Unfortunately, GERD and LPR are often overlooked in infants and children, leading to repeated vomiting, coughing in GERD, and airway and respiratory problems in LPR, such as sore throat and ear infections. Most infants grow out of GERD or LPR by the end of their first year, but the problems that resulted from the GERD or LPR may persist.
What role does an ear, nose, and throat specialist have in treating GERD and LPR?
A gastroenterologist, a specialist in treating gastrointestinal orders, will often provide initial treatment for GERD. But there are ear, nose, and throat problems that are caused by reflux reaching beyond the esophagus, such as hoarseness, laryngeal nodules in singers, croup, airway stenosis (narrowing), swallowing difficulties, throat pain, and sinus infections. These problems require an otolaryngologist—head and neck surgeon, or a specialist who has extensive experience with the tools that diagnose GERD and LPR. They treat many of the complications of GERD and LPR, including: sinus and ear infections, throat and laryngeal inflammation and lesions, as well as a change in the esophageal lining called Barrett’s esophagus, a serious complication that can lead to cancer.
Your primary care physician or pediatrician will often refer a case of LPR to an otolaryngologist—head and neck surgeon for evaluation, diagnosis, and treatment.
How are GERD and LPR diagnosed and treated?
GERD and LPR can be diagnosed or evaluated by a physical examination and the patient’s response to a trial of treatment with medication. Other tests that may be needed include an endoscopic examination (a long tube with a camera inserted into the nose, throat, windpipe, or esophagus), biopsy, x-ray, examination of the esophagus, 24 hour pH probe with or without impedance testing, esophageal motility testing (manometry), and emptying studies of the stomach. Endoscopic examination, biopsy, and x-ray may be performed as an outpatient or in a hospital setting. Endoscopic examinations can often be performed in your ENT’s office, or may require some form of sedation and occasionally anesthesia.
Most people with GERD or LPR respond favorably to a combination of lifestyle changes and medication. Medications that could be prescribed include antacids, histamine antagonists, proton pump inhibitors, pro-motility drugs, and foam barrier medications. Some of these products are now available over the counter and do not require a prescription.
Children and adults who fail medical treatment or have anatomical abnormalities may require surgical intervention. Such treatment includes fundoplication, a procedure where a part of the stomach is wrapped around the lower esophagus to tighten the LES, and endoscopy, where hand stitches or a laser are used to make the LES tighter.
Adult lifestyle changes to prevent GERD and LPR
- Avoid eating and drinking within two to three hours prior to bedtime
- Do not drink alcohol
- Eat small meals and slowly
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Limit problem foods:
- Caffeine
- Carbonated drinks
- Chocolate
- Peppermint
- Tomato
- Citrus fruits
- Fatty and fried foods
- Lose weight
- Quit smoking
- Wear loose clothing
Contact Us
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Tuesday: | 8:00 AM - 5:00 PM |
Wednesday: | 8:00 AM - 5:00 PM |
Thursday: | 8:00 AM - 5:00 PM |
Friday: | 8:00 AM - 12:00 PM |
Saturday: | Closed |
Sunday: | Closed |