Head and Neck Manifestations of "Gastroesophageal Reflux"

	What Is Gastroesophageal Reflux?
	What is Ambulatory 24-Hour pH Monitoring?

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Heartburn is a burning sensation in the center of the chest that often occurs after eating. It is a common, if uncomfortable, sensation. Often, heartburn indicates a condition called gastroesophageal reflux. However, other symptoms such as chronic cough, sore throat or voice changes may also indicate this condition. The following information describes how we diagnose and treat this disorder.

What Is Gastroesophageal Reflux?
When you swallow, food passes down your throat and through your esophagus to your stomach. A muscle called the lower esophageal sphincter controls the opening between the esophagus and the stomach. When this muscle fails to close the opening, the stomach's contents can move back into the esophagus, especially if you are lying down. This backward movement is called reflux. When stomach acid enters the lower part of the esophagus, it can produce a "burning" sensation, usually called "heartburn." If the acid passes higher through the esophagus and enters the lower throat, it can produce other symptoms such as chronic cough, sore throat, difficulty swallowing or voice changes.

Several factors may explain why this reflux action occurs. The most important are:

The position of your body after eating (an upright posture helps prevent reflux),

The size of the meal(smaller meals reduce reflux), and

the nature of what you consume (certain substances that irritate the esophagus or weaken the sphincter can cause reflux.)

What is Ambulatory 24-Hour pH Monitoring?
Ambulatory 24-hour pH monitoring is a method for recording the amount and severity of acidic stomach contents backing up into the esophagus. Twenty-four hour pH monitoring is widely accepted as the standard for evaluation of gastroesophageal reflux and is currently available in our practice.

The test involves placing a small probe or catheter in the esophagus. Placement of the catheter is only mildly uncomfortable and takes just a few minutes. Once the catheter is in place you will be able to breathe, talk and eat with little or no disruption. The probe is connected to a small recording device called a DigitrapperTM . Using a microprocessor, this unit is able to record the pH or acid levels in your esophagus over a 24-hour period.

One of our doctors will review the reflux episodes and how they relate to physical activity, meals, chest pain, heartburn, pressure or other symptoms. Once treated appropriately, most people find relief from the heartburn, pressure or other symptoms that indicate gastroesophageal reflux.