GERD, gastro-oseophageal reflux disease or acid reflux, is a condition where stomach acid travels up the oesophagus and damages the lining. Acid reflux happens when the muscle that is supposed to close off the oesophagus is not functioning properly. In some cases, GERD can cause sinus complications when gastric acid flows up the back of the throat and into the nasal and sinus passages. This can cause sinusitis and postnasal drip. If untreated, GERD can lead to permanent scarring of the esophageal lining and chronic sinus inflammation.
In normal digestion, a muscle called the lower esophageal sphincter, or LES, closes off and prevents stomach acid from entering the oesophagus. When the LES muscle does not properly close, acid can back up the esophageal tract, causing GERD, or what is also commonly referred to as heartburn. Other symptoms of GERD include a highly acidic taste in the mouth, difficulty swallowing, hoarseness and nausea. GERD is a recognised medical condition that can be treated.
Causes of Acid Reflux
The causes of a malfunctioning lower esophageal sphincter include poor posture after eating a meal, a high amount of gastric acid in the stomach during digestion and a hiatus hernia, a condition in which a portion of the stomach extends through the diaphragm. Acid reflux can go beyond the oesophagus; stomach acid can penetrate up the back of the throat and into the nasal and sinus cavities.
Effects on Sinuses
When laryngopharyngeal reflux occurs, delicate mucus membranes are irritated. Pain accompanied by a postnasal drip develops. Acid may back up into the nasal tract during sleep, when the body is in a horizontal position. Because the nasal membranes are sensitive to the slightest irritation, they secrete mucus to counteract the gastric acid and the constant secretions may lead to constant inflammation. Treating the underlying GERD will typically alleviate chronic sinus inflammation.
GERD can afflict people of all ages. Typically, a gastroenterologist will first look for symptoms of severe acid reflux, such as chronic heartburn, nasopharyngeal irritation and difficulties in swallowing. An endoscopic exam is performed to monitor possible damage to the oesophagus from acid reflux. If it is determined that complications from GERD are resulting in severe sinus infections, an otolaryngologist will be consulted for diagnosis and treatment.
Treatment for GERD includes lifestyle changes as well as medical treatment. Changes to the diet include eliminating caffeine, carbonated drinks and acidic foods such as tomatoes and citrus. Medical treatments involve lowering the production of gastric acid. A doctor may prescribe antacid medications such as Cimetidine and Famotidine. Other drugs may be prescribed to increase the function of the esophageal sphincter to prevent acid reflux. If the combination of diet changes and medications do not work, fundoplication surgery is performed; the top of the stomach is wrapped around the oesophagus to strengthen it.