Gastroesophageal Reflux Contributing to Chronic Sinus Disease in Children: A Prospective Analysis

“Wheezing or a cough that mimics asthma or bronchitis can be caused by acid reflux moving from the stomach to the lungs,” says Evan Dellon, MD, the director of the Center for Esophageal Diseases and Swallowing at the University of North Carolina School of Medicine in Chapel Hill, NC. On the other hand, wheezers and coughers can sometimes make themselves more prone to reflux, says Dr. Dellon, because the actions put pressure on the belly and push stomach acid upward. 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.

Many conditions that result in a bad smell in the nose have dehydration as their root cause. How much liquid someone needs each day depends on their age, activity levels, and diet, among other factors.

While GERD is common across ages, laryngopharyngeal reflux is more commonly found in infants due to their undeveloped sphincter. Lying down all the time and a shorter esophagus also contribute to the development of LPR in infants. Another study followed patients between ages 1 to 17 with OME and used anti-reflux therapy to improve the signs of GERD. This study also confirmed that anti-reflux medication helps with patients with resistant-therapy OME, leading them to believe that OME may be directly related to GERD. The scientists tested out antireflux medication on a patient with GERD and OME to understand whether reflux medication would directly alleviate OME symptoms.

reflux symptoms you’re ignoring. “If you’ve tried cutting down on reflux-producing foods or eating late at night and the symptom doesn’t go away, it’s probably just congestion,” says Dr. Sam.

acid reflux and chronic sinus infections

Phosphoric acid, ascorbic acid, citric acid, and “vitamin C added or enhanced” all mean that what’s in the bottle may be as acidic as stomach acid. And if you have significant reflux symptoms, avoid it! Learn more about silent reflux prevention.

She said my ear drums looks really dull which doesn’t mean infection because if it was infection they would be red. She said it’s due to inflammation in my sinuses. She said nodes in my neck don’t seem to be a worry because they’ve been there a while and from blood tests I’ve had done last week they’re all normal so it could simply be my sinuses. Hi – I have GERD & suspected LPR but am on PPIs & have radically altered my diet to be low-acid & low-fat.

Additionally, an oral decongestant and antihistamine may be helpful. Strategies in sinus surgery have therefore turned to optimizing the natural openings while preserving the tissue lining whenever possible. Currently, this is the accepted method of sinus surgery and involves using cameras in the nose to expand the natural drainage paths, wash out secretion, and removing infected material only. In some instances, ENT surgeons can pass a small balloon into the sinus openings and inflate the balloon to expand the pathways-much like a heart doctor can open a blockage in a heart vessel. The vast majority of sinus surgery is done on an outpatient basis, and involves 2-3 visits to the doctor so he or she can check and clean the areas involved.

However, others need more aggressive and lengthy treatment. If this is not effective or if symptoms recur, your doctor may suggest surgery.

In the meantime, I’m listening to these people, and what you often hear is that these patients are coughing repetitively or speaking in a gravelly voice, or the tenor of their speech may be more rapid, or the pitch of their speech may be a little squeaky. Ask the patient what their day-to-day job is. Many of these patients spend a lot of time on the telephone or are singers.

Outside the protected stomach, pepsin, bathed in acid, digests you! And when pepsin attacks your sensitive airway and esophageal tissues, you can suffer all kinds of problems. Nearly 20 percent of Americans suffer from regular bouts of heartburn, acid indigestion and other symptoms of chronic gastroesophageal reflux disease (GERD). When acid repeatedly “refluxes” from the stomach into the esophagus alone, it is known as gastroesophageal reflux disease (GERD). However, if the stomach acid travels up the esophagus and spills into the throat or voice box (called the pharynx/larynx), it is known as laryngopharyngeal reflux (LPR).

A family member might remind the patient, “You aren’t supposed to cough like that — the doctor told you not to clear your throat like that.” If they have to cough, I tell them to try a silent cough, a nonphonated cough. The irritation in the larynx is less injurious with that type of cough. This has been helpful in my practice. What do we do with these patients? I study all of these patients with pH monitoring.

The most common silent reflux symptoms are hoarseness, chronic cough, throat-clearing, post-nasal drip, sinusitis, sore or burning throat, difficulty swallowing, shortness of breath, snoring, sleep apnea, bad breath, tooth decay, asthma, and COPD. Unfortunately, your doctor is probably unaware that these symptoms may be caused by silent reflux and that it could be controlled with the proper diagnosis and treatment. But these also can be symptoms of other problems, such as chronic acid reflux. Acid reflux occurs when stomach acid backs up, or refluxes, out of the stomach and into the esophagus. The chronic type of acid reflux is called gastroesophageal reflux disease, or GERD.

This was because he had a habit of eating dinner very late and then falling asleep on the sofa. Hence, he would reflux into his throat all night.

If the patient has severe reflux without benefit of the above-described treatment, then that individual should be considered for fundoplication if a hiatal hernia is present or marked reflux is objectively documented by pH probe monitoring. There are four major pairs of sinuses surrounding the nasal cavities. They are 1) the frontal sinuses in the forehead area, 2) the maxillary sinuses behind our cheeks, 3) the ethmoid (pronounce ethmoyd) sinuses between our eyes, and 4) the sphenoid (pronounced sfenoyd) sinuses behind our nose and eyes, beneath the front portion of the brain.

Persistent cough or wheezing

Historical pieces such as timing of the onset of symptoms, relieving factors, coincident upper respiratory illnesses (URI) such as a cold, trauma or surgery in the nose or sinuses, and allergy triggers all help to influence an ENT doctor’s suspicion that sinus infection is truly a concern. Examining the nose and sinuses typically involves looking up in the nose with a small camera after numbing the area with a nasal spray.

acid reflux and chronic sinus infections

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