|Posted on July 13, 2010 at 11:43 PM|
By Dr Sonia Suprabha Venugopal,ENT Surgeon,Head and Neck Specialist,Bangalore
To understand what is meant by acid reflux I shall first explain to you what normally occurs in the body
What happens to the food we eat?
When we eat food it is broken into small bits in the mouth and the initial stages of digestion start by the action of the salivary enzymes in the mouth itslef.When we swallow food, food passes down the throat,into the food pipe[ oesophagus] and reaches the stomach.There the food is digested and passes onto the small and large intestine where further digestion and absortion takes place.Finally undigested and waste material is voided from the body.
Ever wondered why food does not come up the food pipe normally?
There is a normal peristaltic movement which propels food in a forward movement down our digestive tract.There is an important sphincter in the food pipe which monitors the passage of food through the food pipe.There is an upper oesophageal sphincter at the top entrance of the food pipe[ oesophagus] and also a very important lower oesophageal sphincter at the lower end of the oesophagus controlling food entry and preventing reflux of stomach contents back into the food pipe.This is the normal situation.
What is acid reflux?
Acid reflux is a condition wherein the stomach contents including partially digested substances, stomach acid, stomach secretion and digestive enzymes reflux up from the stomach into the food pipe[oesophagus]
What is the importance of acid reflux?
In the past few decades scientific advances and research has implicated the ubiquitous "Acid reflux" as the culprit in producing a significant number of diseases and conditions in the upper respiratory tract with impact on the ear,nose,throat , voice box and even the lungs!
How is an ENT Surgeon involved in Acid reflux diseases?
There are 2 distinct type of acid reflux diseases:-
Gastroesophageal reflux disease[GERD] - here acid refluxes only into the oesophagus[foodpipe]
Laryngopharyngeal reflux [LPR]- here acid refluxes even beyond the food pipe and affects the throat, nose,nasopharynx, sinuses,ears,voice box and even the lungs.
The Gastroesophageal reflux disease[GERD] produces symptoms we comonly experience such as heart burn,stomach discomfort.This is what we refer to as "acidity" or "gas" problem.
Laryngopharyngeal reflux disease has more subtle and varied symptoms as the effect of the acid reflux can be in the nose,sinuses, throat , ears or voicebox .The patient and often the general physician does not realise the presence of the acid reflux or the significant causative role it plays in the current symptoms the patient has.Here lies the role of the experienced ENT,Head and Neck Surgeon.
How does the ENT Surgeon diagnose Laryngopharyngel reflux?
The ENT Surgeon wil take a detailed history specific for acid reflux disorder ,look for predisposing factors in your diet and lifestyle and perform a complete head and neck examination. An endoscopic examination in the ENT doctor's consultation room will provide valuable diagnostic insights into the disease and its severity.
Dr Sonia usually does a laryngopharyngoscopic examination in the docotr's consultation room itslef to look for evidence of Laryngopharyngeal reflux.
Other optional investigations include:-
A nasal endoscopy
All these are simple procedures which in expert hands can quickly help arrive at a diagnosis and management strategy.
Imaging studies and endoscopy of the oesophagus and stomach and direct laryngoscopy and hypopharyngoscopy may be advised depending on the individual case.