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Gastroesophageal Reflux Disease (GERD)

Gastroesophageal Reflux Disease (GERD). Presented by: Rachel Lang April 15, 2003 ASC 823 C. GERD. Often called reflux It is the recurring backflow of acid from the stomach into the esophagus. FACTS. According to the U.S. Department of Health and Human Services :

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Gastroesophageal Reflux Disease (GERD)

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  1. Gastroesophageal Reflux Disease(GERD) Presented by: Rachel Lang April 15, 2003 ASC 823 C

  2. GERD • Often called reflux • It is the recurring backflow of acid from the stomach into the esophagus

  3. FACTS • According to the U.S. Department of Health and Human Services : • 7 million Americans suffer from GERD • The incidence of GERD increases dramatically in people over the age of 40

  4. Why GERD occurs • The lower esophageal sphincter (LES) is a tight muscle at the bottom of the esophagus • The LES is designed to relax when the food passes through the esophagus into the stomach • Reflux can occur when the tightness of the LES decreases

  5. Causes of Lowered LES Pressure • High fat and carbohydrates in diet • Alcohol consumption • Tobacco products • Carminatives (peppermint & spearmint) • Acidic fruit juices & tomato-based foods • Some medications (e.g. calcium channel blockers & nitrates) • Forceful abdominal breathing

  6. Diagnostics • Laryngoscopy • 24-hour pH monitoring • Endoscopy

  7. Symptoms of GERD • Hoarseness • Post-nasal drip • Throat pain • Persistent cough • Throat clearing • Dysphagia • Globus sensation • Primary symptom is heart burn

  8. Functionally Abusive Vocal Behaviors • Result from behaviors that attempt to compensate for hoarseness or irritation • This increases severity of original problem symptoms

  9. Voice Problems • Hoarseness • Increase in muscle tension • Restricted vocal tone placement • Hard glottal attack • Glottal fry • Vocal process granulomas • Contact ulcers

  10. Voice Therapy • Easy onset • Throat and neck stretching exercises • Change throat focus to face • Vocal hygiene • Reduce throat clearing

  11. Behavior Modification • Elevate the head of the bed 6 to 8 inches • Take antacids • Eat smaller meals • Chew bicarbonate gum • Chew De-Glycyrrhizinated Licorice (DGL) • Don’t lie down right after meals • Maintain a healthy weight

  12. Avoid • Tobacco • Foods high in fat • Spicy food • Alcohol • Caffeine & Chocolate • Activities that compress the abdomen

  13. Pharmacotherapy Reduce acidity • H2 Antagonists • Over the counter • Pepcid & Zantac • Proton Pump Inhibitors (PPI) • Prescription only • Prilosec, Prevacid, & Nexium

  14. Surgery • Nissen fundoplication • Procedure that tightens the LES • Wraps the upper part of the stomach around the esophagus

  15. Refrences • Ahuja, V., Lassen, L., & Yenchen, M. (1999, September). Head and neck manifestations of gastroesophageal reflux disease. American Family Physician, 60, 873-86. • Boone, D.R. & MacFarlane, S. (2000). The voice and voice therapy (6th ed.). Boston: Allyn and Bacon • Division of Speech and Hearing Sciences at the University of North Carolina. Gastroesophageal reflux disease. Retrieved on April 1, 2003, from http://www.unc.edu/~chooper/classes/voice/webtherapy/gerd/Voice.html • Greater Baltimore Medical Center. Reflux changes to the larynx.. Retrieved on April 1, 2003, from http://www.gbmc.org/voice/refluxchanges.cfm • Scripps Center for Voice and Swallowing. Gastroesophageal reflux disease. Retrived on April 1, 2003, from http://scripps.org/print/printfriendly-article.htm

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