Reflux Laryngitis (cont.)
What types of medications are used to treat reflux?
There are several different types of medications available over the counter
(OTC) or by prescription. The acid-blocking drugs [famotidine
(Pepcid),
cimetidine (Tagamet), nizatidine
(Axid), ranitidine (Zantac)] are known as
H2-blockers. These are available without a prescription. However, their strength
may be inadequate.
Other valuable medications include:
metoclopramide (Reglan), which helps to
empty the stomach; or the proton pump inhibitors, such as omeprazole (Prilosec)
and lansoprazole (Prevacid).
If conservative therapy and medical therapy fail,
surgery may be necessary. Traditionally, the fundoplication procedure, which serves to strengthen the
muscular valve (lower esophageal sphincter), required significant surgical work
and hospital stay. Recently, the surgery has been performed using a viewing tube
instrument (endoscopic fundoplication). This has shortened both hospital stay
and recovery.
What are the difficulties in diagnosing reflux laryngitis?
In some patients it appears clear that the laryngeal
symptoms - hoarseness, cough, sore throat
- are due to reflux, for example, in
patients with marked heartburn and regurgitation of acid.
In most patients with
laryngeal symptoms - those with milder heartburn and no regurgitation who comprise
the majority of patients in whom reflux laryngitis is considered - it is not as
clear. Examination of the larynx may reveal redness and swelling, but these
signs can be caused by many diseases of the larynx as well as reflux.
There are
difficulties with using symptoms to diagnose reflux. For example, cough may
occur when there is reflux into the esophagus. Refluxed liquid does not need to
reach the larynx. There are no well-accepted acid tests to demonstrate that acid
is reaching the larynx.
Finally, it is unclear whether or not refluxed liquid
from the stomach that is not acid can cause reflux laryngitis, and there is no
way of testing whether or not non-acid liquid is reaching the larynx. Many
physicians use a trial of potent acid-suppression with PPIs to try to prove that
acid reflux is the cause of the laryngeal symptoms. The problem with a trial of
PPIs is that some symptoms such as cough and throat clearing can be caused by
habit, and the PPIs may have a placebo effect. Thus, a response to PPIs may not
be proof that reflux is the cause of symptoms.
Next: Reflux Laryngitis At A Glance »
- pantoprazole, Protonix - Explains the medication pantoprazole (Protonix), a drug used for the treatment of gastroesophageal reflux disease (GERD), like other PPI's it also is used for treating ulcers of the stomach and duodenum, and the Zollinger-Ellison Syndrome.
- Endoscopy (Esophagogastroduodenoscopy, EGD) - Learn about the endoscopy procedure which examines the esophagus, stomach and duodenum to detect gastrointestinal and digestive disorders on MedicineNet.com
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