Swallowing Disorders: Acid Reflux
David Sjulin, M.D.
Swallowing disorders are more common as we get older. Difficulty swallowing pills or larger portions of meat is usually related to reflux. As you get older, you can have a hiatal hernia, which causes more reflux problems, and that can cause a narrowing in the esophagus.
What causes acid reflux?
Usually at night, people eat a little too close to going to bed and they have a hiatal hernia, which is a weakening of the muscle that separates the chest from the abdomen. That muscle if it’s weak allows some of the stomach contents to come up into the esophagus and when you lay down that can get all the way in the back of your throat.
How is acid reflux treated?
First thing is lifestyle modifications, so maybe your work is shifted that you do end up eating and laying down right away, so we change that so that you have at least 4 hours between eating and when you lay down, and maybe making that meal that is right before bed, the evening meal, be the smallest one of the day. Elevate the head of your bed so we get acid trying to run up hill, which is difficult to do. So once we’ve made those modifications, we can start with over the counter medications such as Pepcid, Tums, or Rolaids. And for serious cases we can use more complex therapies such as Prilosec and other drugs.
How much acid does it take to cause problems?
The amount of acid that’s required to cause heart burn is a fair amount but the amount of acid to cause problems in the throat with hoarseness or a feeling of fullness may be a very small amount, so if a small amount of acid is coming up at night when you are laying down you may not have any heartburn symptoms, but you may have a fullness in your throat, a feeling like there’s a lump, you need to clear your throat, but you don’t have any heartburn because it’s too small of an amount. The voice box is not supposed to have any acid, so even a small amount can cause symptoms.
When should you see a doctor?
I think it’s very important if you’re having symptoms that relate to swelling that you be checked out so we find out what is causing it. Reflex is usually easy treated so patients can recover and be symptom free fairly quickly.