Silent reflux (LFR) may cause the following complaints:
• Feeling of a mass in the throat,
• Excessive throat clearing,
• Long-lasting, ticklish cough,
• A feeling of being stuck in the throat,
• Hoarseness,
• Heartburn,
• Pain or tenderness in the throat,
• A bad, bitter taste in the mouth (especially in the morning),
• Nasal discharge,
• Asthma-like respiratory complaints,
• Difficulty reaching high notes while singing
What is reflux?
When a meal is eaten, it passes through the pharynx and reaches the stomach. When food reaches the stomach, it mixes with the acid and pepsin (a digestive enzyme) produced by the stomach to ensure digestion. A muscular structure surrounding the entrance of the stomach prevents the stomach contents from escaping backwards into the pharynx. If this structure
does not work well enough, stomach acid and pepsin leak back, this situation is called Reflux. Gastroesophageal Reflux Disease (GER) is the escape of excessive amounts of stomach acid and other stomach contents into the esophagus. This disease causes complaints such as heartburn, sourness and pain. (pharynx) and back into the larynx (larynx). Classic reflux complaints such as heartburn and heartburn are generally not observed in these patients. That's why the name Silent Reflux is also used. The throat, larynx and vocal cords are much more sensitive to stomach acid and digestive enzymes than the esophagus. Therefore, Silent Reflux causes more damage.
What are the drugs used for the treatment of Silent Reflux?
A group of drugs called proton pump inhibitors are used in the treatment of silent reflux. There are many
drugs in this group. Sometimes, a patient who does not respond to a drug may respond with another drug.
However, it should not be forgotten that the drug alone is not effective and nutritional and lifestyle changes must be made.
Laryngopharyngeal reflux (LFR) What can be done for treatment and prevention? • Foods: You should pay attention to how your own body responds to which food. So, you can determine which foods cause reflux. You can find it sitting there. However, in general, it will be beneficial to stay away from foods that increase reflux.
• These foods: hot, spicy and acidic foods, acidic drinks (e.g. orange juice, grape juice), excessive fat
foods, fast food, excessively caffeinated drinks such as coffee and tea, some spices such as mint, chocolate and
alcohol.
• Avoid overeating. Excessive fullness of the stomach increases the chance of reflux. Eat small amounts of food in multiple meals instead of one or two large meals a day.
• Do not lie down or lie down within 3 hours after eating or drinking. Try to move your dinner
hours earlier. If you must eat something late at night, try to buy lighter
and low-fat foods.
• Stress: Try to reduce tension and stress in your life. Because the amount of reflux increases due to stress.
• Try to lose your excess weight. Excess weight significantly increases reflux.
• Do not wear clothing that hugs your body tightly. Do not bend over or do heavy work after eating.
• Elevate the head of your bed. For this, place 8-10 cm under the feet at the head of your bed. You can put thick
wooden blocks or thick books.
• If you smoke, please quit as soon as possible. This alone will significantly reduce your reflux.
How long should LPR treatment be continued?
LPR is a disease that lasts for a long time (chronic) and reoccurs intermittently. For this reason, reflux
may reoccur for a number of reasons (e.g. stress, fatigue and diet, etc.) after the complaints and symptoms disappear and the treatment is stopped completely. Therefore, in general, LPR patients need intermittent
treatment. Although the duration of LFR treatment varies from person to person, it lasts approximately 4-6 months
. Surgical treatment may be recommended for patients with very severe LPR who do not respond to drug treatment.
Here, the esophageal sphincter is tightened by surgery.
Definition:
Reflux, one of today's common diseases, is actually GER (Gastroesophageal Reflux) and LFR
(Laryngopharyngeal Reflux) There are two different forms expressed as: GER
(Gastroesophageal Reflux) is the leakage of stomach acid content into the esophagus, and people with this disease usually consult internal medicine doctors. However, in the more common LFR (Laryngopharyngeal Reflux)
disease, this acid content passes through the esophagus and reaches the pharynx and from there to the larynx, behind the vocal cords. These patients usually have to consult an ENT specialist.
Causes:
Overweight, fat-rich diet, habit of eating late at night, stress, changes in stomach position (hernia). , etc.), the valve between the stomach and the esophagus cannot be completely closed, which may cause the acid in the stomach to reach the esophagus and, if it progresses further,
to the throat.
Disease. Its course:
Since the disease continues for a long time with very mild symptoms and complaints that do not suggest stomach disease, it is usually treated with incorrect diagnoses or is not taken seriously by the patient.
This also causes tissue destruction. increases and causes healing to be delayed. Patients usually use antibiotics for a long time with diagnoses such as
pharyngitis or tonsillitis.
Findings:
Dry cough (especially increasing after lying down), hoarseness, voice fatigue, sore throat and Complaints such as burning sensation, frequent
need to clear the throat, frequent pharyngitis, sinusitis and tonsillitis attacks, and postnasal drip suggest the presence of reflux.
Examination and Tests:
Edema, redness and tissue swellings seen at the back of the larynx during vocal cord examination performed by endoscopic method are considered as changes caused by reflux. The acid secretion coming from the stomach and passing through the esophagus
passes over the upper esophageal valve and spills overflowing into the trachea. This is the back surface of the larynx and all changes begin to occur here. These findings suggest the presence of reflux. Tests to be performed for LFR (Laryngopharyngeal Reflux)
are used to detect the irritation caused by reflux, such as barium esophagus radiographs and acid perfusion test
These are tests for
and their diagnostic values are low because they do not directly detect LFR (Laryngopharyngeal Reflux). Esophageal endoscopy and biopsy of the mucosa are the first examinations to be performed in patients with typical reflux findings and lead directly to diagnosis. p>
Treatment:
There are three options in the treatment of LFR (Laryngopharyngeal Reflux). These; Social adjustments made in lifestyle and daily habits (food regimen, combating excess weight, etc.), the use of drugs that reduce and neutralize acid secretion, and surgical treatment.
Prevention and Precautions:
In addition to drug treatment, some simple adjustments to living conditions play an important role in preventing reflux. Elimination or correction of eating habits and living conditions are precautions that must be followed in every
period of treatment. The most important of these are listed below:
• It is useful to keep the upper body and head elevated while lying down. For this purpose, the number of pillows can be increased
or the head of the bed can be raised.
• It is recommended to sleep on your left side.
• Care should be taken to have dinner as early as possible; Care should be taken to ensure that there is at least a 2-3 hour period between after eating and sleeping.
• Excess weight should be lost. Because it will increase the intra-abdominal pressure, the complaints may intensify. • Care should be taken to consume mint, mint candy, chocolate, excessively fatty and heavy sweet foods as little as possible. Because such foods reduce the pressure of the valve between the esophagus and stomach and delay stomach emptying. • Spicy foods, tomatoes and their products, garlic, onion, orange juice, cola, citric acid drinks and
coffee. ; In patients whose esophagus is known to be sensitive to acid, they may cause symptoms by directly stimulating the esophageal sensory receptors.
• It would be appropriate to follow a diet containing low-fat and protein-rich foods. Instead of overeating, frequent and small amounts of food should be preferred.
• Care should be taken not to consume alcohol and cigarettes.
• Clothes that tighten the abdominal area, corsets, belts, tight trousers and belts should not be used.
• White Eating roasted chickpeas and chewing gum can sometimes be useful in preventing complaints.
• Some exercises may cause reflux.
• Some medications you are using may increase reflux.
• Increased intra-abdominal pressure during pregnancy may also cause reflux.
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