16 July, 2018
Could You Have Acid Reflux and Just Not Know It?
Acid Reflux can be difficult to diagnose because the symptoms could be mistaken for other ailments. Here's why acid reflux could be the culprit.
After months of hoarseness, I went to an ear, nose and throat doctor to try and figure out what was causing my voice to alter so dramatically. It seemed like I was always on the cusp of laryngitis, and I occasionally felt as if I had a lump in my throat, so I got to Googling my symptoms. My imagination ran wild as I considered the possibilities of nodes on my vocal chords or even worse — throat cancer. Imagine my surprise when, after looking down my throat for all of 30 seconds, my ENT said I had a classic case of acid reflux.
“Acid reflux is one of the most commonly misdiagnosed diseases afflicting Americans,” says Jamie Koufman, M.D., director of the Voice Institute of New York, clinical professor of otolaryngology in the Mt. Sinai Medical System and author of many books on the topic, including the upcoming “Acid Reflux in Children: How Healthy Eating Can Fix Your Child’s Asthma, Allergies, Obesity, Nasal Congestion, Cough & Croup.”
In fact, reflux-related diseases affect at least half of all Americans and are rising at an alarming rate. And reflux-caused esophageal cancer has increased by more than 850 percent to become the fastest-growing (by incidence) cancer in the United States, Koufman says.
Evaluate Your Symptoms
Lawrence B. Cohen, M.D., professor of medicine and gastroenterology at the Icahn School of Medicine at Mount Sinai Hospital in New York, says that while typical symptoms of reflux, such as heartburn, belching and regurgitation, are generally easy to recognize, sufferers can also experience what’s called “silent reflux,” which causes a wide variety of atypical symptoms, such as hoarseness, cough, repetitive throat clearing and breathlessness. Dr. Koufman adds to that list postnasal drip, sore throat, hoarseness, a lump-on-the-throat sensation and difficulty swallowing. Because these symptoms can also be caused by other health issues, silent reflux can be tricky to diagnose.
If you are diagnosed with acid reflux, you’ll want to take steps to heal your esophagus and prevent long-term complications of reflux, which include ulcers of the esophagus and the development of precancerous growths. There is no one way to treat it: Some patients with gastroesophageal reflux disease (GERD) can be adequately managed with just diet and lifestyle changes, while more severe cases can need long-term medication or even surgery.
Adjust Your Diet
A few things Dr. Cohen says you can do on your own to keep symptoms at bay: Maintain your ideal weight, nix cigarettes, too much booze and fatty foods and sleep on a 45-degree incline to keep stomach acid from rising up through your esophagus while you slumber.
Also, Dr. Koufman says that when you eat might just as important as what you eat when managing your symptoms. “Having dinner too late is the number-one risk factor for reflux; the kitchen should close four hours before bedtime for refluxers,” she says. As far as what to eat, Koufman recommends a clean (preservative-free) diet of lean proteins, green vegetables, alkaline water (Koufman herself conducted a study on its efficacy) and what’s referred to as an alkaline diet to keep acid production at a minimum.
Do You Need Meds?
Though there are a numerous over-the-counter meds to counter reflux symptoms, Dr. Koufman says people should know there are two different types of medications generally prescribed for acid reflux that work very differently — PPIs (proton-pump inhibitors) and H2As (histamine 2-antagonists). PPIs reduce acid in your stomach by blocking the enzyme in the wall of the stomach that produces it. They include Nexium, Prilosec, Protonix, Dexilant, omeprazole, pantaprazole and more. And according to Dr. Koufman, they never should have been sold over the counter.
“First, they have side effects that include diarrhea, abdominal pain and headaches. Second, when they are discontinued many people experience ‘rebound hyperacidity,’ or a worsening of their symptoms. Third, PPIs have been reported to be associated with heart attacks, kidney disease, Alzheimer’s disease, esophageal cancer and death. In my opinion, PPIs should be prescribed only by physicians and should never be used long-term,” she says, adding that she stopped using PPIs completely in her practice three years ago.
The other class of reflux meds she mentions — H2As — work similarly, by sending a signal to your acid-releasing stomach cells to ease up. They include ranitidine (Zantac), famotidine (Pepcid) and cimetidine (Tagamet), but they don’t have the same disconcerting side effects. Still, you should only use them for longer than two weeks if under a doctor’s care.
Think you might have acid reflux? See a doctor to evaluate the severity of your condition and determine your best course of treatment. You might have to weigh the severity of your symptoms against the risks associated with the medications. With more awareness of the disease and its symptoms, we should start to see a decline in those alarming cancer statistics.