Gastroesophageal Reflux (GER) and Laryngopharyngeal Reflux (LPR)

Your doctor has determined that reflux of stomach acid may be responsible for many of your symptoms, including hoarseness, throat clearing, cough, difficult or painful swallowing, and/or heartburn. Effective treatment begins with lifestyle changes described below, and may also include medications designed to neutralize stomach acid or minimize its production. Please follow the instructions outlined below for at least six weeks:

• Bed blocks: Elevate the head of your bed with two 6-inch blocks or bricks. Although using a foam wedge beneath the upper half of your body is an alternative, using extra pillows is not effective.
• Avoid foods that cause your symptoms: Caffeine, chocolate, carbonated beverages, alcohol, mints, onion, garlic, tomato and citrus fruit or juices, spicy and fatty foods.
• Do not lie down for two hours after eating: Allow gravity to work. Also, avoid bending over at the waist to pick things up; instead, bend at the knees.
• Eat smaller meals: Instead of one or two very large meals during the day, consume three or four smaller meals; this minimizes overfilling of your stomach.
• Avoid tobacco use: If you are unable to stop smoking, decrease the number of cigarettes you smoke; this is the single greatest improvement in your health that you can control.
• Maintain your ideal body weight: Excess weight increases the amount of pressure on your stomach, and even a small amount of weight loss may help to alleviate this.
• Avoid tight clothing: Tight belts, tight pants, or girdles can increase the pressure on the abdomen and stomach.
• Avoid medications that cause your symptoms, if possible: Non-steroidal anti-inflammatory medications such as aspirin and ibuprofen, and oral steroids such as prednisone should be avoided, if possible; patients taking aspirin for protection of their heart and blood vessels should consult their primary care doctor or cardiologist before discontinuing this medication.
• Medications that may be recommended: 1) Liquid antacid – take two teaspoons one hour after each meal and just before bedtime; many over-the-counter choices are available, including MAALOX^® and RIOPAN^®. 2) PEPCID^® or Tagamet^®, if prescribed by your doctor; these medications are also available over-the-counter. 3) PREVACID^®, PRILOSEC^®, ACIPHEX^®, Protonix^®, or Nexium^®, if prescribed by your doctor.