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8/14/2019 GERD Presentation RL

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Gastroesophageal Reflux Disease

(GERD)

Presented by: Rachel Lang

April 15, 2003ASC 823 C


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GERD

Often called reflux

It is the recurring backflow of acid from

the stomach into the esophagus


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FACTS

According to the U.S. Department of

Health and Human Services :

7 million Americans suffer from GERDThe incidence of GERD increases dramatically

in people over the age of 40


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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 foodpasses through the esophagus into the

stomach

Reflux can occur when the tightness of theLES decreases


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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


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Diagnostics

Laryngoscopy

24-hour pH monitoring

Endoscopy


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Symptoms of GERD

Hoarseness

Post-nasal drip

Throat pain

Persistent cough

Throat clearing

Dysphagia

Globus sensation

Primary symptom is heart burn


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Functionally Abusive Vocal

Behaviors

Result from behaviors that attempt to

compensate for hoarseness or irritation

This increases severity of original problem

symptoms


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Voice Problems

Hoarseness

Increase in muscle tension

Restricted vocal tone placement

Hard glottal attack

Glottal fry

Vocal process granulomas

Contact ulcers


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Voice Therapy

Easy onset

Throat and neck stretching exercises

Change throat focus to face Vocal hygiene

Reduce throat clearing


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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)

Dont lie down right after meals

Maintain a healthy weight


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Avoid

Tobacco

Foods high in fat

Spicy food Alcohol

Caffeine & Chocolate

Activities that compress the abdomen


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Pharmacotherapy

Reduce acidity

H2 Antagonists

Over the counter

Pepcid & Zantac

Proton Pump Inhibitors (PPI)Prescription only

Prilosec, Prevacid, & Nexium


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Surgery

Nissen fundoplication

Procedure that tightens the LES

Wraps the upper part of the stomach aroundthe esophagus


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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

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