Spring in Michigan can mean respiratory problems. Seasonal allergies can flare with weather change and pollen counts. It seems almost unrealistic that signs and symptoms of year-round or seasonal nasal mucus, sinus congestion, sneezing, wheezing, etc. would be caused by anything but allergy.
A patient reported similar "sinus problems" since the 1950's. His situation was not the result of allergy but instead the body responding to refluxed gastric contents.
Recent gastroesophageal reflux (GERD) treatment has helped immensely. New literature reveals that only one-third of these respiratory symptoms are due to allergy. Despite identical problems, the remaining two-thirds suffer from some non-allergic cause.
Antihistamines only help when an allergy is present. Decongestants assist in controlling symptoms in either group but can give incomplete results or unwanted side effects.
Interchangeable respiratory problems due to laryngopharyngeal reflux (LPR), a form of GERD, are not allergy induced. Thus LPR is one outward display of acid digestive juices from the stomach regurgitating into the esophagus.
Amazingly, LPR symptoms can occur without heartburn. Often the only distinguishing feature of LPR is poor outcomes with allergy therapy. Success with treatment for GERD confirms the cause of the symptoms as LPR. Incomplete response to allergy therapies and resolution of symptoms with treatment for GERD is surprisingly common.
Successful treatment in the person who has long suffered is particularly gratifying. Treatment for LPR ("sinus-GERD") includes: raising the head of the bed; sleeping on the left side of the body; avoiding caffeine, chocolate, mint and using antisecretory medication.
An interesting July 25, 2008 article from Webb MD helps explain the asthma and GERD connection: "Chronic heartburn may alter the immune system and raise the risk of asthma, according to a new study that helps explain why so many people with asthma also suffer from gastroesophageal reflux disease (GERD).
Researchers say the link between asthma and GERD has been a mystery for years. Previous studies have shown that 50 percent to 90 percent of people with asthma also suffer from gastric reflux, but until now the relationship between the two conditions was unclear.
The study shows that inhaling small amounts of stomach acid back up into the esophagus and lungs, a hallmark of GERD, slowly produces changes in the immune system that may lead to the development of asthma."
An article released in CHEST from the United Kingdom documented from the study of 3 million patients charts that patients with a diagnosis of chronic obstructive pulmonary disease (COPD) are at a significantly increased risk of GERD. COPD is commonly known as emphysema.
They also observed respiratory symptoms improve in patients receiving acid-suppressive therapy for GERD. Since the symptoms and diagnosis of asthma and emphysema commonly overlap it is prudent (but relatively uncommon) to consider GERD as a connecting theme.
GERD is often associated with heartburn/indigestion but it is entirely possible to have GERD associated with asthma, emphysema and allergies and have little or no heartburn. This type GERD is thus called "atypical" or "silent."
Dr. Kurt Barrett has a family practice in Athens, MI.