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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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gastroesophageal reflux disease gerd

Gastroesophageal Reflux Disease(GERD)

Presented by: Rachel Lang

April 15, 2003

ASC 823 C

slide2
GERD
  • Often called reflux
  • It is the recurring backflow of acid from the stomach into the esophagus
facts
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
why gerd occurs
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
causes of lowered les pressure
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
diagnostics
Diagnostics
  • Laryngoscopy
  • 24-hour pH monitoring
  • Endoscopy
symptoms of gerd
Symptoms of GERD
  • Hoarseness
  • Post-nasal drip
  • Throat pain
  • Persistent cough
  • Throat clearing
  • Dysphagia
  • Globus sensation
  • Primary symptom is heart burn
functionally abusive vocal behaviors
Functionally Abusive Vocal Behaviors
  • Result from behaviors that attempt to compensate for hoarseness or irritation
  • This increases severity of original problem symptoms
voice problems
Voice Problems
  • Hoarseness
  • Increase in muscle tension
  • Restricted vocal tone placement
  • Hard glottal attack
  • Glottal fry
  • Vocal process granulomas
  • Contact ulcers
voice therapy
Voice Therapy
  • Easy onset
  • Throat and neck stretching exercises
  • Change throat focus to face
  • Vocal hygiene
  • Reduce throat clearing
behavior modification
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
avoid
Avoid
  • Tobacco
  • Foods high in fat
  • Spicy food
  • Alcohol
  • Caffeine & Chocolate
  • Activities that compress the abdomen
pharmacotherapy
Pharmacotherapy

Reduce acidity

  • H2 Antagonists
    • Over the counter
    • Pepcid & Zantac
  • Proton Pump Inhibitors (PPI)
    • Prescription only
    • Prilosec, Prevacid, & Nexium
surgery
Surgery
  • Nissen fundoplication
    • Procedure that tightens the LES
    • Wraps the upper part of the stomach around the esophagus
refrences
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