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Research into the linkage of the
digestive and respiratory systems has yielded solid evidence of
relationships between reflux and asthma, and even more remotely,
between reflux and inner ear inflammation. These far reaching reflux
effects are logical when one considers that the stomach is an
intensely harsh environment in which from three to four and a half
liters of hydrochloric acid are secreted on a daily basis . .
. in addition to digestive enzymes. Somewhat surprisingly, an acidic
environment is not necessary for the effective digestion of food;
note that modern reflux medications are very effective at
suppressing acid production. The purpose of stomach acidity is to
comb out potentially harmful microbes in our food, and activate
pepsinogen into the primary digestive enzyme, pepsin.
Treatment of laryngopharyngeal
reflux
A proton pump inhibitor (PPI) suppresses
the chemical messenger that stimulates acid production factories
(proton pumps) within parietal stomach cells. This powerful class of
medications used include: Nexium, Prilosec/Omeprazole, Prevacid,
AcipHex, and Protonix. PPIs produce the most adverse reactions in
users; 1% experience headache, diarrhea or constipation, abdominal
pain, flatulence (gas), nausea/vomiting, or dry mouth.
Relatively less aggressive and effective
histamine blockers such as Zantac, Tagamet, and Pepcid exert a
different mechanism of acid control via the jamming of
intra-cellular proton pumps. Both PPIs and histamine blockers are
effective for between ½ and ¾ of a 24 hour period, therefore double
dosing each day may be necessary.
Common antacids buffer secreted acid, and
are the least aggressive medications for reflux intervention.
Antacids may also create a foam barrier in the lower esophagus and
upper stomach which aids in reflux containment for up to ninety
minutes. Basic recommendations specify head of bed elevation and
antacid use prior to sleep.
There may be additional merit in a drug
such as Pepcid Complete which combines both a histamine blocker and
antacid. Likewise, it is possible to combine a PPI and histamine
blocker (e.g., Nexium in the morning and Zantac at night), or double
dose each class.
All the aforementioned medication classes
are now available over-the-counter; however, it would be
most
Reflux
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