Midwest Voice Conference : Diagnostic Evaluation and Medical Treatment of Adult Patients with GERD
What is GERD?
According to the American College of Gastroenterology, GERD is defined as:
“Chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus.”
Do you have acid reflux?
If so, this lecture presented by Dr. Jay L. Goldstein will teach you the basic principals of gastroesophageal reflux (GERD), help you to understand how reflux can get to and affect the vocal folds, and learn about treatment options.
GERD is not fun, particularly if you rely on your voice to make a living.
Symptoms associated with GERD include:
- Typical symptoms other than heartburn:
- Atypical Symptoms
Atypical Symptoms of GERD
- Throat clearing
- Dental erosion
- chest pain
- Chronic cough
- Sore throat
Without going into too much detail as to the scientific explanation and how GERD happens, it’s basically triggered by acid-peptic attacks that weakens cells leading to a widening of gaps between the cells allowing acid to penetrate.
Penetration of acid and pepsin allows for acid to make contact with the nerve, and as a result, disrupts intracellular mechanisms leading to cell rupture — reflux!
(Explanation paraphrased as explained on a diagram from Orlando. Am J Gastroenterol 1996)
Let’s take a look at some dietary factors that may aggravate GERD symptoms.
Dr. Goldstein suggested the following as potential aggravators:
- Caffeinated products
- Fatty foods
- Spicy foods
- Citrus fruits and juices
- Tomato-based products
Food is one factor in that may aggravate GERD, but certain medications may also play a part in aggravating GERD symptoms by impairing LES function and medications that may aggravate GERD symptoms by damaging the esophageal mucosa.
It’s All About Acid!
Management of Non-erosive Reflux Disease
GERD strikes most people at night time when going to sleep, but it is also prevalent throughout the day at meal times, running on a 24 hour cycle, usually becoming more severe with each meal, and the dinner hour being the most disruptive for GERD symptoms.
You can manage non-erosive GERD by taking charge and making some lifestyle changes such as:
- Raise the head of the bed, or lie on left side
- Decrease fat intake
- Avoid certain foods
- Avoid lying down for 3 hours after eating
- Stop smoking
- Lose weight if appropriate
There are several different types of reflux disease (non-erosive, erosive, complicated, and refractory), and to learn more, I recommend you consult your doctor should these be areas of concern for you.
About Jay L. Goldstein, MD
Professor of Medicine
Vice Head for Clinical Affairs
University of Illinois at Chicago
Dr. Jay L. Goldstein is a gastroenterologist at the University of Illinois Medical Center at Chicago. After completing his fellowship in gastroenterology, he joined the faculty at the University of Illinois at Chicago in 1984, where he is currently Professor of Medicine and Vice Head for Clinical Affairs. Dr. Goldstein is a Fellow in the American College of Physicians (FACP), American College of Gastroenterology (FACG) and the American Gastroenterological Association (AGAF).
Any comments, tips or thoughts you’d like to share?
Looking forward to hear about any methods you’ve found to alleviate GERD to help you with your voice over performance.