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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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