Definition of Reflux laryngitis
Reflux laryngitis: Inflammation of the voice box
(the larynx) caused by stomach acid backing up into the esophagus.
Reflux laryngitis is associated with chronic hoarseness and symptoms
of esophageal irritation such as heartburn.
Reflux is caused by a weakness in the muscle at the junction
of the esophagus (food tube) and the stomach. Normally, this
sphincter muscle opens to allow food to go down to the
stomach and closes to keep the stomach's contents from coming back
up. The backward movement of stomach contents up into the esophagus
is gastroesophageal reflux.
The refluxed stomach acid irritates the lining of the esophagus,
larynx and throat. This can lead to erosion of the lining of the
esophagus (erosive esophagitis), narrowing of the esophagus
(stricture), chronic hoarseness, chronic throat clearing, difficulty
swallowing, cough, spasms of the vocal cords and growths on the vocal
cords (granulomas). Reflux also increases the risk of cancer of the
esophagus and larynx.
Heartburn is the most common symptom of reflux. Other symptoms
include non-cardiac chest pain, chronic hoarseness, asthma, or the
feeling of a foreign body in the throat (the globus phenomenon).
Treatment includes:
- Antacids neutralize stomach acid and give immediate relief.
Popular choices include sodium bicarbonate (Alka Seltzer), calcium
carbonate (Tums, Rolaids, Alka-Mints), and aluminum and magnesium
antacids (Maalox, Mylanta, Riopan, Gaviscon), all best used 30-60
minutes after each meal and at bedtime.
- Try to have your largest meal of the day at noon.
- Give the stomach several hours to empty before you go to
bed. Try not to eat after your evening meal.
- Avoid spicy or fried foods, peppermint, citrus, tomatoes,
onions, and chocolate, especially if these foods increase symptoms.
- Try eating a diet that is high-protein, high-carbohydrate,
and low-fat.
- Avoid lying down after you eat. It is often helpful to
elevate the head of your bed with wooden blocks under the bedposts to
allow gravity to keep the acid in the stomach. Pillows under the head
are of negligible benefit.
- Avoid alcohol, caffeinated beverages, and tobacco.
- Weight loss, if indicated.
- Avoid drugs such as nonsteroidal anti-inflammatory drugs
(aspirin, ibuprofen, etc.), theophylline (in tea, too),
anticholinergics, and calcium channel blockers.
Medications available for treating reflux include the histamine H2
receptor antagonists cimetidine (Tagamet), ranitidine (Zantac), and
famotidine (Pepcid) which are available by prescription or at lower doses without a prescription. Other valuable drugs that require a prescription are the proton pump inhibitors (PPI's) including omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium).
Last Editorial Review: 3/26/1998 2:28:00 PMCommon Misspellings: reflux laringitis
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