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Midwest Voice Conference : Diagnostic Evaluation and Medical Treatment of Adult Patients with GERD

By Stephanie Ciccarelli

August 12, 2008

Comments (5)

Dr. Jay L. Goldstein

What is GERD?

According to the American College of Gastroenterology, GERD is defined as:

"Chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus."

Do you have acid reflux?

If so, this lecture presented by Dr. Jay L. Goldstein will teach you the basic principals of gastroesophageal reflux (GERD), help you to understand how reflux can get to and affect the vocal folds, and learn about treatment options.

GERD is not fun, particularly if you rely on your voice to make a living.


Symptoms associated with GERD include:

๏ Heartburn
๏ Typical symptoms other than heartburn:
- Regurgitation
- Dysphagia
๏ Atypical Symptoms


Atypical Symptoms of GERD

๏ Throat clearing
๏ Globus
๏ Laryngospasm
๏ Dental eroison
๏ Chest pain
๏ Hoarseness
๏ Chronic cough
๏ Sore throat
๏ Wheezing

Without going into too much detail as to the scientific explanation and how GERD happens, it's basically triggered by acid-peptic attacks that weakens cells leading to a widening of gaps between the cells allowing acid to penetrate.

Penetration of acid and pepsin allows for acid to make contact with the nerve, and as a result, disrupts intracellular mechanisms leading to cell rupture -- reflux!

(Explanation paraphrased as explained on a diagram from Orlando. Am J Gastroenterol 1996)


Let's take a look at some dietary factors that may aggravate GERD symptoms.

Dr. Goldstein suggested the following as potential aggravators:

๏ Caffeinated products
๏ Peppermint
๏ Fatty foods
๏ Chocolate
๏ Spicy foods
๏ Citrus fruits and juices
๏ Tomato-based products
๏ Alcohol


Food is one factor in that may aggravate GERD, but certain medications may also play a part in aggravating GERD symptoms by impairing LES function and medications that may aggravate GERD symptoms by damaging the esophageal mucosa.


It's All About Acid!

Management of Non-erosive Reflux Disease

GERD strikes most people at night time when going to sleep, but it is also prevalent throughout the day at meal times, running on a 24 hour cycle, usually becoming more severe with each meal, and the dinner hour being the most disruptive for GERD symptoms.

You can manage non-erosive GERD by taking charge and making some lifestyle changes such as:

๏ Raise the head of the bed, or lie on left side
๏ Decrease fat intake
๏ Avoid certain foods
๏ Avoid lying down for 3 hours after eating
๏ Stop smoking
๏ Lose weight if appropriate


There are several different types of reflux disease (non-erosive, erosive, complicated, and refractory), and to learn more, I recommend you consult your doctor should these be areas of concern for you.


About Jay L. Goldstein, MD

Professor of Medicine
Vice Head for Clinical Affairs
University of Illinois at Chicago

Dr. Jay L. Goldstein is a gastroenterologist at the University of Illinois Medical Center at Chicago. After completing his fellowship in gastroenterology, he joined the faculty at the University of Illinois at Chicago in 1984, where he is currently Professor of Medicine and Vice Head for Clinical Affairs. Dr. Goldstein is a Fellow in the American College of Physicians (FACP), American College of Gastroenterology (FACG) and the American Gastroenterological Association (AGAF).


Any comments, tips or thoughts you'd like to share?

Looking forward to hear about any methods you've found to alleviate GERD to help you with your voice over performance.

Best wishes,

Stephanie

Related Topics: acid reflux, Chicago, Dr. Jay L. Goldstein, GERD, Midwest Voice Conference, throat


Comments


    I am a GERD sufferer, and have been since college (15 years or so). I used to wake up in the middle of the night with a mouth full of acid and a terrible burning in my throat. Even once I rinsed the area and took multiple antacids, I would still have the burning feeling (think about it: when you get a sun burn or burn your hand on the stove, it keeps hurting even after the agent that caused the burn is removed, doesn't it?). I would use Chloroseptic throat drops to numb my throat. It never seemed to effect my voice.

    I was a pharmacy tech at the time, so I learned all about medications to help treat it. First came Pepcid and Zantac and other H2 inhibitors. Unfortunately, they are barely more effective than placebo, and did very little to help me. Next came Prilosec and the like (proton pump inhibitors) and they are WAAAAYY more effective. I take a daily Prilosec (thankfully it is now OTC). But, I am still careful about what I eat. Acidic and greasy foods are my main triggers. Spicy foods are ok, and so are caffeine and chocolate. Losing weight would probably help, but then again I was 20 pounds lighter in college when the issue first started for me, so maybe not. Anyhow, I have learned to manage my condition and I rarely have reflux anymore.

    Posted by:
    • Jerome Santucci
    • August 12, 2008 7:33 PM

      Hi Jerome,

      Thank you for commenting and sharing your story. I'm glad you've found a way to manage your GERD. I really appreciate hearing from you and encourage others to also comment.

      Best wishes,

      Stephanie

      Posted by:

        Hey Stephanie. Thank you for the post! Jerome, sadly, the H2 blockers are only effective is about 50% of cases. So, they're better than nothing FOR SOME PEOPLE, and for some, like candy. Like Stephanie, I'm glad you've gotten it under control. Feel free to e-mail at civc@uic.edu if you have any questions or would like more information.

        Posted by:
        • Steve Sims
        • August 13, 2008 11:39 AM

          I too suffer from GERD and have found an all natural and safe CURE it takes 6 months to year depending on the individual.
          I personally am almost off of nexium, after a few Months.

          It is a product that I plan on being a distributor for called... ULTIMATE ALOE.
          If anyone has any questions please feel free to email me...

          Posted by:

            Just a word of caution, I have no problem with anyone trying Ultimate Aloe. However, to be clear, all natural and safe are not synonomous. Tetrodotoxin naturally occurs in some fish and will kill very quickly. I am all for aloe products and colostrum and have used a variety of products to help patients with reflux. However, it is not necessarily true that sometime that occurs in nature is always safe so I'm always cautious when I see "natural and safe"

            Posted by:
            • voicedoc
            • August 18, 2008 12:23 PM

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