Gastroesophageal Reflux: When Acid Reaches the Nasal Cavity

Q: Gastroesophageal Reflux: When Acid Reaches the Nasal Cavity

Hello： 1. <br>During the period of significant symptoms, it is recommended to use medication regularly, and once symptoms improve, gradually reduce the dosage. <br>2. <br>If you have already been careful with your diet, consider whether constipation is causing indigestion or dela

Gastroesophageal reflux that reaches the nasal cavity?

Hello Doctor: It all started on January 23 with "heartburn," which I thought was a mild symptom, so I first consulted a traditional Chinese medicine practitioner.
On the night of January 26, I noticed that I experienced acid reflux into my "throat" while sleeping.
The next day, I visited a Western medicine doctor who prescribed the following medications: famotidine, aluminum hydroxide, and stigmin-c.
(*Initially, I had some issues with bowel movements.) After taking the medication, I felt some discomfort in my stomach, but it subsided shortly after.
After taking the medication for one day, I had no symptoms the next day and thought I was better, so I stopped taking the medication.
On January 29, during a family gathering, after eating normally, the symptoms returned.
It seems that the antacids may have suppressed the symptoms for too long, making it easy for them to recur after stopping the medication.
Therefore, I only take the medication when the symptoms are severe (I finished 9 packets of medication in two weeks).

On the night of February 7, I started experiencing acid reflux "into my nasal cavity," so I elevated my pillow.
For the second and third weeks, I managed my diet, eating until I was 70-80% full and avoiding sweets, but my symptoms did not improve.
In addition to continuing to see a traditional Chinese medicine practitioner, I returned to the Western medicine doctor on February 13.
I asked the doctor if I could take the medication at night or when the symptoms were severe, and he said it was fine, but recovery would be slow.
The symptoms are now entering the fourth week; is this considered severe? If gastroesophageal reflux is mild, can it be treated in a few months? (I understand that it is prone to recurrence and that I should avoid many irritating foods like sweets and take good care of myself.)
Is this type of gastroesophageal reflux considered "chronic," meaning that the medication needs to be taken for a long time? If it were you, would you recommend taking the medication twice a day or just once? Thank you.

wei shi dao niu liu, 20~29 year old female. Ask Date: 2017/02/13

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: 1.
During the period of significant symptoms, it is recommended to use medication regularly, and once symptoms improve, gradually reduce the dosage.
2.
If you have already been careful with your diet, consider whether constipation is causing indigestion or delayed gastric emptying, which fundamentally relates to the issue of constipation.
You may want to revisit a gastroenterologist, and if necessary, undergo an endoscopy.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.

Reply Date: 2017/02/13

More Info

Gastroesophageal reflux disease (GERD) is a condition where stomach acid flows back into the esophagus, leading to symptoms such as heartburn, regurgitation, and discomfort in the throat. Your experience of acid reflux reaching the nasal cavity is not uncommon and can be attributed to a phenomenon known as laryngopharyngeal reflux (LPR). This occurs when stomach contents, including acid, travel up the esophagus and reach the throat and even the nasal passages, causing symptoms like throat irritation, post-nasal drip, and a sensation of mucus in the throat.

The relationship between GERD and nasal symptoms is complex. When acid reaches the throat, it can irritate the mucosal lining, leading to inflammation and increased mucus production. This can result in post-nasal drip, where mucus accumulates in the back of the throat, causing discomfort and the need to clear the throat frequently. Additionally, the irritation can lead to a chronic cough or a sensation of a lump in the throat, known as globus sensation.

Your symptoms began with heartburn and progressed to acid reflux during sleep, which is a common trigger for GERD symptoms. Elevating the head while sleeping can help reduce nighttime reflux by utilizing gravity to keep stomach contents in the stomach. However, if symptoms persist despite lifestyle modifications and medication, it may indicate that the underlying condition is not adequately managed.

In terms of treatment, it is essential to adhere to the prescribed medication regimen. Proton pump inhibitors (PPIs) or H2 blockers are commonly used to reduce stomach acid production and alleviate symptoms. However, as you noted, stopping medication can lead to a rebound effect, where symptoms may return or worsen. This is particularly true for PPIs, which can lead to increased acid production if discontinued abruptly after prolonged use.

Regarding your question about the duration of treatment, GERD can indeed be a chronic condition requiring long-term management. While some individuals may experience relief within a few months, others may need to continue treatment for an extended period, especially if they have lifestyle factors that contribute to their symptoms, such as diet, obesity, or smoking.
As for the frequency of medication, it is crucial to follow your healthcare provider's recommendations. If your doctor suggested taking medication as needed, it may be beneficial to establish a consistent routine, such as taking it twice daily, especially if you experience symptoms regularly. This can help maintain a steady level of medication in your system and provide better control over your symptoms.

In summary, GERD can lead to a range of symptoms, including those affecting the throat and nasal cavity. The relationship between acid reflux and nasal symptoms is significant, and managing GERD effectively often requires a combination of medication, lifestyle changes, and ongoing monitoring. If your symptoms persist or worsen, it is advisable to consult with your healthcare provider for further evaluation and potential adjustments to your treatment plan.

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