Sore Throats

If you have ever experienced acid reflux, you know that the symptoms can be very

uncomfortable. When the esophageal sphincter at the bottom of the esophagus is not

functioning properly, the stomach acids entering the esophagus from the stomach cause a

burning of the esophageal sphincter, and can also lead to irritation and pain of the rest

of the esophagus as well. The top of the esophagus is commonly known as the throat, which

is why acid reflux and sore throats often go hand in hand.

Some people do not realize they are suffering from acid reflux and sore throats seem like

they might just be a symptom of a cold or the flu, and so they drink tea to soothe their

throats, and perhaps take painkillers. Leaving acid reflux untreated can damage your

esophagus if it becomes more acute, however, causing scarring to the throat or even

bleeding ulcers in the stomach and digestive system. How can you tell if your sore throat

is caused by acid reflux? It may be worsened by lying down, and probably feels more

irritated after eating a meal, which is when acid reflux usually asserts itself. If you

think you are experiencing acid reflux and sore throats, see your doctor. There are several

solutions he or she may suggest.

Chest Pain

Almost every acid reflux sufferer experiences severe chest pains. It is so common to experience chest pain due to acid reflux that sometimes when people are actually having a heart attack they think it’s just acid reflux again and therefore don’t go to the hospital or get proper medical care.

Chest Pain or None in Acid Reflux – What’s the Difference?

In acid reflux sufferers who have chest pains, there doesn’t seem to be a difference in levels of acid, nor in the levels of aggravation of acid reflux when compared to acid reflux sufferers who don’t have chest pain. Right now it’s a mystery to doctors as to why some people experience acid reflux and chest pain while some only have the acid reflux. But dealing with the acid reflux is the same either way.

Acid reflux and chest pain can be dangerous if it’s not treated right, as well as being terrible uncomfortable. When acid leaves the stomach, is gathers in the esophagus or alimentary canal. The acid has to be neutralized, or eventually it will damage the esophagus and you’ll get bleeding ulcers – painful! So doctors are cautious to check the acid levels in the stomach and esophagus both before the treatment and during it, to make sure no damage is being done.

Dealing with Acid Reflux and Chest Pain Quickly and Easily

As soon as you are diagnosed with acid reflux and chest pain, you can get treatment that will relieve your symptoms and make you feel much better right away. Whether you are choosing traditional medications, or alternative treatments like herbal medicine, you’ll find the best first step is to stop smoking or drinking alcohol. It’s also important to eat small meals and snacks, more than three times a day. This will ensure that your stomach is never empty – an empty stomach will tend to produce more acid later when you do get to eat – and more acid is the last thing the acid reflux and chest pain sufferer wants! Try carrying small snacks with you at all times, because you never know when you might find yourself in a long meeting or heavy traffic.

In combination with your prescribed medications, if you eat smaller, more frequent meals, and stop drinking and smoking, you’ll find your acid reflux and chest pain much easier to manage.

Nighttime Heartburn May Be Dangerous

Why is heartburn more dangerous at night? There are several reasons this may be the case, and why heartburn sufferers should take precautions.

When symptoms of Gastroesophageal Reflux Disease (GERD) occur at night, they can be more damaging than those same symptoms during the day. If you are a GERD sufferer, you know how your symptoms can cause problems, such as the pain and the irritation. When you sleep at night, your body is less prepared to deal with these symptoms, and less able to prevent possible lasting damage. While we know from experience that acid reflux at night can disrupt our sleep, we also need to understand the other potentially harmful factors that can make nighttime heartburn more likely to cause damage.

These factors include:

* Sleeping in a supine position.
Laying flat in bed allows stomach acid to flow more easily into the esophagus, and stay there more longer periods of time then when a person is in an upright position.Even elevating the head and shoulders 6 to 8 inches will help keep stomach acid where it belongs, in the stomach.

* We can't drink or swallow every time an acid reflux episode occurs when sleeping.
When GERD sufferers are awake and there's an episode of acid reflux, they often will rinse their mouth or swallow some liquid. Even swallowing saliva helps. When asleep, once the refluxed acid is in the esophagus or throat, the sufferer isn't always aware of it, and thus doesn't take steps to rinse the acid away.

* There's an increased risk of choking on refluxed stomach contents.
If refluxed acid is in the throat and mouth, a GERD sufferer can inhale this into their lungs. Once in the lungs, it can cause a GERD sufferer to cough and choke on this aspirated material. The acid can also cause the same damage to the lungs as it can cause when refluxed into the esophagus.


Anyone who is troubled with nighttime GERD symptoms should talk to their doctor. There are medications that can help control the acid reflux. The doctor can also discuss preventive measures a GERD sufferers can use to help prevent damage that can occur with nighttime reflux.

Importance of non-acidic reflux

Acid reflux clearly is injurious to the esophagus. What about non-acid reflux? As previously discussed, there are potentially injurious agents that can be refluxed other than acid, for example, bile. Esophageal acid testing accurately identifies acid reflux and has been extremely useful in studying the injurious effects of acid. Until recently, however, it has been impossible or difficult to accurately identify non-acid reflux and, therefore, to study whether or not non-acid reflux is injurious or can cause symptoms. A new technology allows the accurate determination of non-acid reflux. This technology uses the measurement of impedence changes within the esophagus to identify reflux of liquid, be it acid or non-acid. By combining measurement of impedence and ph it is possible to identify reflux and to tell if the reflux is acid or non-acid. It is too early to know how important non-acid reflux is in causing esophageal damage, symptoms, or complications, but there is little doubt that this new technology will be able to resolve the issues surrounding non-acid reflux.
GERD At A Glance

* GERD is a condition in which the acidified liquid contents of the stomach backs up into the esophagus.
* The causes of GERD include an abnormal lower esophageal sphincter, hiatal hernia, abnormal esophageal contractions, and slow emptying of the stomach.
* GERD may damage the lining of the esophagus, thereby causing inflammation (esophagitis), although usually it does not.
* The symptoms of uncomplicated GERD are heartburn, regurgitation, and nausea.
* Complications of GERD include ulcers and strictures of the esophagus, Barrett's esophagus, cough and asthma, throat and laryngeal inflammation, inflammation and infection of the lungs, and collection of fluid in the sinuses and middle ear.
* Barrett's esophagus is a pre-cancerous condition that requires periodic endoscopic surveillance for the development of cancer.
* GERD may be diagnosed or evaluated by a trial of treatment, endoscopy, biopsy, x-ray, examination of the throat and larynx, 24 hour esophageal acid testing, esophageal motility testing, emptying studies of the stomach, and esophageal acid perfusion.
* GERD is treated with life-style changes, antacids, histamine antagonists (H2 blockers), proton pump inhibitors (PPIs), pro-motility drugs, foam barriers, surgery, and endoscopy.

Management of Barrett's esophagus

Only 10% of patients with GERD have Barrett's esophagus. Some physicians have suggested that all patients with GERD should be screened with endoscopy for the presence of Barrett's. Then, if they have Barrett's, they can undergo regular endoscopic surveillance for the development of cancer. For most physicians, however, screening all patients with GERD seems unreasonable since it would require a tremendous increase in the cost of care for patients with GERD. One study suggested that cancer of the esophagus develops more often in patients who have had heartburn more frequently and/or for a longer period of time. Accordingly, perhaps screening for Barrett's esophagus is realistic only for those GERD patients with frequent and long-standing heartburn. However, studies have yet to demonstrate the value of this approach.

Periodic surveillance for cancer is recommended in patients with Barrett's esophagus. Yet, there also may be a role for other treatments. For example, since reflux is believed to be the cause of Barrett's esophagus, it is possible that early and aggressive treatment of GERD (elimination of virtually all reflux) will prevent the progression of Barrett's esophagus to cancer. Additionally, newer experimental techniques that destroy the Barrett's cells (e.g., laser or electrocautery) also may prevent the progression to cancer. Studies are needed in Barrett's to evaluate both the aggressive therapy of GERD and the destructive therapy of Barrett's for the prevention of esophageal cancer.

Although Barrett's esophagus clearly is a pre-cancerous condition, only a minority of patients with Barrett's esophagus will develop cancer. Moreover, periodic endoscopic surveillance for cancer is expensive and each endoscopy puts a patient at a slight risk for complications of endoscopy. Thus, investigators are seeking better ways of determining which patients with Barrett's are more likely to develop cancer and need more frequent endoscopic surveillance and which patients need infrequent surveillance or, perhaps, no surveillance. Accordingly, they are evaluating newer techniques (for example, analysis of the cells' DNA) to examine in more detail the altered cells in the esophagus of patients with Barrett's. In this way, the investigators are trying to identify cellular changes that can predict the later development of cancer.

The standard treatment for early cancers in Barrett's esophagus is surgical removal of a portion of the esophagus (esophagectomy). This is major surgery. However, several experimental procedures that do not require surgery are being evaluated for treating early cancers. For example, photodynamic therapy is a procedure in which the cancers are destroyed with light after they have been sensitized to the light by the intravenous injection of light-sensitizing chemicals.

Mechanism of heartburn and damage

One unresolved issue in GERD is the inconsistent relationships among acid reflux, heartburn, and damage to the lining of the esophagus (esophagitis and the complications). Why do only a few of the many episodes of acid reflux that occur in a patient with GERD cause heartburn? Why do some patients with mildly increased acid reflux develop heartburn, while other patients with the same amount of acid reflux do not? Why does heartburn usually occur in an esophagus that is not damaged? Why is it that some patients with more damage to the esophagus have less heartburn than patients with no damage? Clearly, we have much to learn about the relationship between acid reflux and esophageal damage, and about the processes (mechanisms) responsible for heartburn. This issue is of more than passing interest. Knowledge of the mechanisms that produce heartburn and esophageal damage raises the possibility of new treatments that would target processes other than acid reflux.

One of the more interesting theories that has been proposed to explain some of these questions involves the reason for pain when acid refluxes. It often is assumed that the pain is caused by irritating acid contacting an inflamed esophageal lining. But the esophageal lining usually is not inflamed. It is possible therefore, that the acid is stimulating the pain nerves within the esophageal wall just beneath the lining. Although this may be the case, a second explanation is supported by the work of one group of scientists. These scientists find that heartburn provoked by acid in the esophagus is associated with contraction of the muscle in the lower esophagus. Perhaps it is the contraction of the muscle that somehow leads to the pain. It also is possible, however, that the contraction is an epiphenomenon, that is, refluxed acid stimulates pain nerves and causes the muscle to contract, but it is not the contraction that causes the pain. More studies will be necessary before the exact mechanism(s) that causes heartburn is clear.