REFLUX

Reflux is a term describing the back flow of stomach contents. For example, after eating, food should stay in the stomach and be digested. If you have reflux, the food and stomach contents travel back up the digestive tract.
LPR, laryngopharyngeal reflux, is when food or stomach acid backflow up into the larynx (voice box) or pharynx (throat).

Heartburn is caused by a continual, day after day, reflux into the esophagus. Many people with LPR do not suffer from heartburn because the contents that are refluxed do not stay in the esophagus for long because of this, the acid does not have time to inflame the esophagus.

Signs of LPR

For the doctor to diagnose whether or not you have LPR, two tests may be preformed: a barium swallow or pH-metry. During a barium swallow, the patient drinks a liquid that can be seen by an x-ray. The barium swallow test allows the doctor to see if there is narrowing or other abnormalities of the throat and esophagus. If the doctor does not perform the barium swallow test, the doctor may recommend the pH-metry test. This test is performed to measure the acid in your esophagus by placing a small, accommodating tube in your nose and through your throat for 24 hours. These tests are performed by gastroenterologists, stomach doctors. The tube is connected to a small computer, worn around your waist, that measures the acid in the esophagus. A newly available test involves implantation of a pH monitor in your esophagus. The pH-metry test is the best way to determine the course of treatment to effectively cure LPR.

SLEEP APNEA

As you sleep, your body relaxes its muscles. If you have a small throat, this relaxing of muscles can cause your throat to become narrower, making breathing more difficult. This is called Obstructive Sleep Apnea and Snoring. Other factors that cause breathing difficulty during sleep are a smaller-than-normal jaw, a large tongue, enlarged tonsils or tissues that block the air entrance. Alcohol, sleeping pills and tranquilizers when taken before bed further muscle relaxation which could cause your throat to collapse.

Sleep apnea does not allow the body to receive fresh air. The brain tells your body to wake up for a moment, to tighten the throat muscles and unblock the air passage. This can cause an insufficient amount of sleep. The lack of sleep and fresh air can damage your lungs, heart and other organs, which can cause high blood pressure, a heart attack or a stroke.

Your doctor may recommend an air pressure device called continuous positive airway pressure (CPAP) to treat OSAS, or your doctor may advise an oral device. CPAP works by having an air blower connected by a hose to a mask. Every night when you go to bed, you place the mask over your nose and turn on the blower. This device sends a constant flow of air through your nose to your throat. The steady stream of air keeps the throat from collapsing and blocking your air passage. Oral devices work in many different ways: Some hold the tongue forward, others keep the jaw a little forward, and another is made to lift the uvula and soft palate. Each oral device is created to keep objects from blocking your air passage.

If other treatments are not successful, your doctor may suggest Uvulapalatopharyngoplasty (UPPP), a surgery that removes the uvula, part of the soft palate, and tonsils. This surgery usually hinders further snoring, but is less successful in treating OSAS because the air passage may be blocked further back in the throat. Another surgery that may be recommended is Electrosurgical uvulopalatoplasty (ESUP). ESUP removes part or all of the uvula and part of the soft palate. Once again this surgery will more than likely quiet snoring but may not cure OSAS.

Other procedures which may help sleeping and OSAS:

• Remove polyps or straighten the septum.
• Remove enlarged tonsils or adenoids.
• Move jaw and tongue forward to enlarge the air passage.
• Tracheostomy, a surgery in which doctors make an opening in the breathing tube in the neck.

Many children and some adults experience problems with their tonsils and adenoids that may result in the need to remove one or both or these problematic areas.

Tonsils are located in the back of the mouth on either side. When they become enlarged or infected, various problems can occur such as interference with breathing or swallowing and pain and discomfort from tonsillitis. If these symptoms occur, you may need a tonsillectomy, a surgical procedure in which the tonsils are removed.
Adenoids are located in the back of the nasal passage. Enlarged or infected adenoids can impair hearing, hinder breathing and cause ear infections. A surgical procedure called adenoidectomy can alleviate these symptoms by removing the adenoids.

Both tonsillectomy and adenoidectomy are minor, same-day surgeries.