Swallowing Disorders: Acid Reflux – Boys Town Ear, Nose & Throat Institute

Swallowing disorders are more common as we
get older. Difficulty swallowing pills or larger portions
of meat is usually related to reflux. As you get older, you can have a hiatal hernia,
which causes more reflux problems, and that can cause a narrowing in the esophagus. Usually at night, people eat a little too
close to going to bed and they have a hiatal hernia, which is a weakening of the muscle
that separates the chest from the abdomen. That muscle if it’s weak allows some of
the stomach contents to come up into the esophagus and when you lay down that can get all the
way in the back of your throat. First thing is lifestyle modifications, so
maybe your work is shifted that you do end up eating and laying down right away, so we
change that so that you have at least 4 hours between eating and when you lay down, and
maybe making that meal that is right before bed, the evening meal, be the smallest one
of the day. Elevate the head of your bed so we get acid
trying to run up hill, which is difficult to do. So once we’ve made those modifications,
we can start with over the counter medications such as Pepcid, Tums, or Rolaid. And for serious cases we can use more complex
therapies such as Prilosec and other drugs. The amount of acid that’s required to cause
heart burn is a fair amount but the amount of acid to cause problems in the throat with
hoarseness or a feeling of fullness may be a very small amount, so if a small amount
of acid is coming up at night when you are laying down you may not have any heartburn
symptoms, but you may have a fullness in your throat, a feeling like there’s a lump, you
need to clear your throat, but you don’t have any heartburn because it’s too small
of an amount. The voice box is not supposed to have any
acid, so even a small amount can cause symptoms. I think it’s very important if you’re
having symptoms that relate to swelling that you be checked out so we find out what is
causing it. Reflex is usually easy treated so patients
can recover and be symptom free fairly quickly.

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