What Is Acid Reflux?

What Is Acid Reflux?

Have you ever had heartburn? What about a burning in your throat? These could be symptoms of acid reflux.

Experiencing the symptoms of acid reflux once in a while is common, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). However, approximately 20% of the U.S. population is affected by a more serious form of reflux.

To understand exactly what acid reflux is, we turned to Michael M. Johns, MD, a laryngology specialist and director of the USC Voice Center at Keck Medicine of USC. Johns, who is also a professor of clinical otolaryngology-head and neck surgery at the Keck School of Medicine of USC, offers an in-depth overview of acid reflux, including its causes, symptoms and treatment options.

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What is acid reflux?

Acid reflux occurs when acidic stomach juices back up from the stomach into the esophagus. This acid sometimes spills into the larynx.

Are there different types of acid reflux?

There are two different kinds of acid reflux: Gastroesophageal reflux (GERD) and laryngopharyngeal reflux (LPR). A person can have one or both kinds of reflux.

What are the differences between GERD and LPR?

GERD occurs when stomach acid flows up from the stomach into the esophagus. It usually occurs at night when people are reclined.

Symptoms may include: heartburn, belching, regurgitation of stomach contents and swallowing difficulties.

LPR occurs when stomach acid travels up through the esophagus and spills into the larynx or pharynx (voice box). It can occur during the day or night. The acid irritates the vocal folds and surrounding tissues. As the acid moves quickly up through the esophagus into the larynx, patients with LPR often do not experience heartburn.

Symptoms may include: hoarseness, excessive mucus (throat clearing), post-nasal drip, coughing, throat soreness or burning, choking episodes (can wake person up out of a sound sleep), difficulty swallowing or feeling of a lump in the throat.

How is acid reflux treated?

Reflux can be treated through dietary and lifestyle modifications, medications — usually proton pump inhibitors (PPIs), and in some cases, surgery is a treatment option. Certain foods are more likely to cause acid reflux. You can reduce incidences of reflux by removing or limiting these foods.

Lifestyle modifications:

  • Do not lie down or exercise directly after eating or wear clothing that is tight around the waist.
  • Eat 3 to 4 small meals a day instead of 2 to 3 large ones.
  • If you are overweight, try to lose weight.
  • Tobacco can cause reflux, so reducing or stopping smoking can be helpful.
  • Do not eat anything 2 to 3 hours before going to bed.
  • If reflux is occurring at night, elevate the head of your bed 4 to 6 inches by putting phone books under the legs of your bed or buying a wedge pillow. Using 2 or more regular pillows can make reflux worse as it causes the body to curl.

How to take reflux medication:

If you are taking one PPI a day, take it in the morning on an empty stomach 30 minutes to an hour before eating breakfast. If you take two PPIs a day, take one in the morning and the other one (on an empty stomach) 30 minutes to an hour before dinner.

How long before I see an improvement?

It can take 4 to 6 weeks for acid burns in the esophagus and larynx to heal, so do not stop medication or dietary or lifestyle modifications without consulting your doctor. It can take 3 to 4 months for full resolution.

What problems can acid reflux cause?

Long-term reflux can cause laryngeal ulcers or granulomas, vocal fold scarring, pneumonia, Barrett’s esophagus and, in some cases, esophageal or throat cancer.

If you’re in Southern California and would like to schedule an appointment with a specialist at the USC Voice Center, you can call (800)USC-CARE (800-872-2273) or visit https://ent.keckmedicine.org/patient-information/request-an-appointment/</a