Gastroesophageal reflux disease, often referred to as GERD, occurs when acid from the stomach backs up into the esophagus. Normally, food travels from the mouth, down through the esophagus and into the stomach. In those who have GERD, the LES does not close properly, allowing acid and other contents of the digestive tract to move up — to reflux — into the esophagus. When stomach acid touches the sensitive tissue lining the esophagus and throat, it causes a reaction similar to squirting lemon juice in your eye.
This is why GERD is often characterized by the burning sensation known as heartburn. In some cases, reflux can be silent, with no heartburn or other symptoms until a problem arises. During gastroesophageal reflux, the contents of the stomach and upper digestive tract may reflux all the way up the esophagus, beyond the upper esophageal sphincter a ring of muscle at the top of the esophagus , and into the back of the throat and possibly the back of the nasal airway.
This is known as laryngopharyngeal reflux LPR , which can affect anyone. Adults with LPR often complain that the back of their throat has a bitter taste, a sensation of burning, or something stuck. Some patients have hoarseness, difficulty swallowing, throat clearing, and difficulty with the sensation of drainage from the back of the nose postnasal drip.
Some may have difficulty breathing if the voice box is affected. Many patients with LPR do not experience heartburn. In infants and children, LPR may cause breathing problems such as: cough, hoarseness, stridor noisy breathing , croup, asthma, sleep-disordered breathing, feeding difficulty spitting up , turning blue cyanosis , aspiration, pauses in breathing apnea , apparent life-threatening event ALTE , and even a severe deficiency in growth.
Proper treatment of LPR, especially in children, is critical. The symptoms of GERD may include persistent heartburn, acid regurgitation, nausea, hoarseness in the morning or trouble swallowing. Some people have GERD without heartburn. Instead, they experience pain in the chest that can be severe enough to mimic the pain of a heart attack.
