• Extraesophageal symptoms are the result of exposure of the upper aerodigestive tract to the gastric juice. This causes a variety of symptoms, including hoarseness, postnasal drip, sore throat, difficulty swallowing, indigestion, wheezing, chronic cough, globus pharyngis and chronic throat-clearing. Some people with LPR have heartburn, while others have little or none of this symptom. This is because the material that refluxes does not stay in the esophagus for very long. In other words, the acid does not have enough time to irritate the esophagus.^[9]

   

  Adults who are afflicted with LPR often experience the acrid taste of bile emanating from the back of their throat. This is also likely to be accompanied by a lump-like sensation in the throat, making it difficult to swallow. The throat may also seem to burn and breathing can be difficult. These symptoms are most often prevalent just after w

• king. ^[10]

   

  [edit] Diagnosis

• When medical management fails, Nissen fundoplication can be offered.^[17]

   

  [edit] References

1 more annotation...

• Gastroesophageal reflux disease (GERD), gastro-oesophageal reflux disease (GORD), gastric reflux disease, or acid reflux disease is a chronic symptom of mucosal damage caused by stomach acid coming up from the stomach into the esophagus.^[1]

   

  GERD is usually caused by changes in the barrier between the stomach and the esophagus, including abnormal relaxation of the lower esophageal sphincter, which normally holds the top of the stomach closed; impaired expulsion of gastric reflux from the esophagus, or a hiatal hernia. These changes may be permanent or temporary ("transient").

   

  Another kind of acid reflux, which causes respi

• Below is a list of foods/drinks that commonly cause irritation and/or heartburn:  
   
  • Alcohol
   
  • Black pepper
   
  • Chili and chili powder
   
  • Citrus fruit, pineapple
   
  • Coffee
   
  • Garlic
   
  • Spicy food
   
  • Tea
   
  • Tomatoes, tomato sauce, tomato juice, ketchup
   
  • Vinegar
   
   Some patients with acid reflux say these gassy foods cause discomfort: 
   
  • Beans
   
  • Broccoli
   
  • Brussel Sprouts
   
  • Cabbage
   
  • Cauliflower
   
  • Kale
   
  • Fizzy drinks (sodas)
   
   Medications
• • Acid suppressant - these have been shown to be effective, such as histamine2-receptor antagonists (blockers). Histamines are good at reducing inflammation. An inflamed stomach produces more acid - blocking this extra production of acid helps prevent the acids from building up and seeping upwards.
  
   
  • Propton pump inhibitors - these reduce the production of acid in the stomach. They act on cells in the stomach wall and produce stomach acids.
  
   
  • Prokinetic agents - these promote the emptying of the stomach, stopping it from becoming overfull.
  
   
  • Antiacids - commonly used to treat mild acid-related symptoms, such as heartburn or indigestion. They neutralize the acids in the stomach. These are not recommended for frequent heartburn for patients with GERD.

• Generic Name	Brand Name
  Omeprazole	Prilosec®*, Losec®*, Omesec®*
  Omeprazole with sodium bicarbonate	Zegerid®*
  Lansoprazole	Prevacid®*
  Pantoprazole	Protonix®
  Rabeprazole	Aciphex®
  Esomeprazole	Nexium®
  Dexlansoprazole	Dexilant®

  *

  Available over the counter.

• • Possible side effects of H2RAs include headache, constipation, diarrhea, nausea, or vomiting.

  • PPIs can have side effects such as diarrhea, nausea, vomiting, pain in your abdomen (belly), upset stomach, and headache.

  • PPIs may increase your chance of getting an infection in your intestines (diarrhea) or lungs (pneumonia). They may also increase your chance of breaking a bone. These side effects are less common, however.

• Tagamet OTC

     

   

   

    May 9, 2011 

   

   

        

     

        

     

   

    

  Tagamet OTC is the over the counter version of a medication that was only previously available by prescription from a physician. This medication, which is the brand name form of cimetidine, was cleared by the Food and Drug Administration for over the counter distribution in 1994, and has since, remained one of the top treatments for gastric ulcers and acid reflux, as well as GERD and the related symptoms like heartburn, frequent belching and stomach upset.

   

   

  Who Uses Tagamet OTC

   

  Tagamet OTC is designed for use by individuals ages 12 and over. Younger children should not use such medications without seeing a physician first.  Older adults who develop heartburn, ulcers or other conditions for which Tagamet is a common treatment protocol, should also see a physician. Any individual who takes other prescription medications should see a physician or at least consult a pharmacist to rule out drug interactions before starting any new over the counter medication.