Otolaryngology department

Steps you can take What tests might my doctor order?

1. Watch what you eat: Esophageal pH Probe Study Some foods such as citrus and tomato-based products in- This measures acid levels in patients complaining crease the amount of stomach acid while other foods such of heartburn.

as garlic and onions allow the lower esophageal stomach A long, flexible tube is inserted into the esophagus via contents to splash back into the esophagus and throat. the nose and remains in place for 24 hours. PH-metry Learning Foods to Avoid: is the best test for LPR and it can help your doctor · Citrus Foods (such as orange and pineapple juice) determine the best treatment for you. · Alcohol This diagnostic test is usually performed only if the About · Tomato-Based Foods patient has atypical symptoms such as pain or cough- · Carbonated Beverages ing. Patients are not usually admitted to the hospital for this test. Acid Reflux · Peppers and Spicy Foods · Caffeine Barium Swallow (Esophagram) or Modified · Peppermint Barium Swallow · Garlic and Onions Barium swallows are performed as part of a · Chocolate gastrointestinal tract examination. The patient · Fatty Foods drinks a “shake” with barium in it. Using x-rays, the radiologist then tracks the barium through the body. 2. Watch when you eat: The test is used to: Eat dinner approximately two to four hours before going to bed. Do not snack right before bedtime. · Evaluate the possible causes of heartburn, such as hiatal hernia 3. Raise your head: · Detect ulcers or tumors Elevating your head and upper body by six to eight inches inhibits reflux when you are lying down. Place a foam wedge under the head of your mattress.

4. Other Lifestyle Changes May Be Beneficial:

· Weight loss · Avoid exercise near bedtime ® · Avoid tight fitting clothes Ertan Esmer, MD Justin Pavlovich, MD · Limit aspirin and ibuprofen Tigard Medical office · Attempt to stop smoking 9250 SW Hall Blvd | Tigard, OR 97223 · Prescription medication phone | 503-293-0161 x4057 fax | 503-452-3213

[10164 07/08] [10164[10390 09/08] 12/09] THEPORTLANDCLINIC.COMTHEPORTLANDCLINIC.COM Otolaryngology department

Why you have throat symptoms What are the symptoms of LPR?

At both ends of the esophagus are the esophageal Symptoms may include:

What is Acid Reflux? sphincters (muscles). These muscles relax to allow food · Chronic hoarseness to pass and then tighten in order to help contain acid. Acid reflux occurs when highly acidic contents · Frequent throat clearing When the LES (lower esophageal sphincter) does not from the stomach are returned into the esophagus · Coughing and throat. tighten enough, acid can reflux from the stomach into · Feeling of a “lump” in the throat the esophagus. If the UES (upper esophageal sphincter) What is GERD? doesn’t tighten enough, the acid can continue upward · Difficulty swallowing into the larynx (voice box) and pharynx (throat). The · Sour or acid taste GERD stands for Gastroesophageal Reflux Disease. tissue lining of the pharynx is much more sensitive to · Postnasal drainage Inside the stomach are acidic juices that are supposed the acid than esophagus lining. In many cases, this may Symptoms may occur at anytime, but you may notice to be there to help break down and digest food. This cause the throat symptoms you are experiencing. them most when you are lying down. acid can wash back out of the stomach and into the esophagus. Therefore, GERD is the return of acidic How is LPR treated? stomach contents into the esophagus. Although treatment should be individualized, there are This may occur because: several general steps you should take. Your doctor will suggest the best treatment plan for you. 1. There is an increased amount of acid in the Nasal Cavity stomach. Medications to Treat Acid Reflux Mouth 2. The LES (lower esophageal sphincter) muscle UES (Upper Your doctor will most likely prescribe medication to may be too loose or relaxed allowing the acid Esophageal Sphincter) help manage your reflux, such as Proton Pump Inhibitors to splash out of the stomach into the esophagus. Larynx (Voice Box) (PPIs). These medications work best if taken one hour Esophagus prior to a meal. What is LPR? Liver LES LPR stands for Laryngopharyngeal Reflux. This is the backflow of acidic stomach contents beyond Stomach the esophagus into larynx (voice box) or the Pancreas (Behind Stomach) pharynx (throat). Large Intestines Small Intestines

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