GERD – Hello Doctor

Hoarse voice? It could be vocal cord nodules!

November 23rd, 2020 by The Hello Doctor Team

Nodules and polyps are growths in the midpoint of your vocal folds. They can change the way your voice sounds.

When you talk, air moves from your lungs through the vocal folds to your mouth. The vocal folds vibrate to produce sound so when you use your voice the wrong way, your vocal folds may swell. Your vocal folds are inside your voice box and anything that makes it harder for the vocal folds to vibrate can cause a voice problem.

Vocal cord nodules are growths that form on the vocal folds. They’re benign and not cancerous. Over time, the swollen spots can get harder, larger and stiffer if you continue to abuse your voice.

Polyps are bigger than nodules and they can occur on one or both vocal folds. They may look like a swollen spot or bump, a blister, or a thin, long growth.

To get a better understanding, think of a nodule as callous and polyp as a blister.

Vocal nodules typically make your voice hoarse, and it may sound raspy or breathy too.

When you have vocal nodules, you will find it difficult to hold a note for long periods of time. You may also struggle to sing very high or low notes or speak in a very high or deep voice.

Causes

Vocal cord nodules usually develop due to chronic abuse of the voice over time, like continued straining, shouting and frequent singing. Ongoing friction between the vocal cords creates callous-like growths.

Gastroesophageal reflux disease (GERD) can cause more swelling and inflammation, which worsens symptoms of vocal cord nodules.

Symptoms

Hoarseness
A rough, scratchy or harsh-sounding voice
Shooting pain from ear to ear
Feeling like you have lump in your throat
Neck pain
Less ability to change your pitch
Voice and body fatigue

How are vocal cord disorders diagnosed?

Should there be any changes in your voice that last for more than 2 weeks, be sure to inform your doctor.

Vocal cord nodules can be diagnosed using the following procedures:

Laryngoscopy: Your doctor will place a spaghetti-like camera in your nose and down the throat. This is done to have a look at the voice box, or larynx.

Stroboscopy: A small, thin, flexible endoscope with a camera is gently inserted through the nose to the area in the back of the throat above the vocal cords. This evaluates the motion and vibration of your vocal cords when there are concerns regarding the strength, pitch and quality of your voice.

Treatment

It can take time and patience for vocal nodules to heal. You will need to practice vocal hygiene and voice therapy.

The practice of good vocal hygiene includes:

Avoiding shouting and screaming
Drinking plenty of water
Maintaining a healthy diet

Try and manage symptoms of reflux and allergies. Usually the swelling of the vocal folds that lead to nodules are triggered by regurgitation, so reflux management is strongly recommended.

References:

Do you struggle with heartburn? Avoid these foods

August 7th, 2019 by Content Editor

Heartburn is a painful burning sensation in the top section of your stomach, which spreads up into your throat. This happens when acid rises into your oesophagus, the tube that connects your stomach to your mouth.

Also known as acid reflux, it can come from spicy foods, overeating in general, or from stress. There are also some medications that can cause heartburn.
Heartburn symptoms can range from burning in the chest to a sour acidic taste in the back of your throat.

To keep acid reflux at bay, avoid the following triggers:

Spicy foods

Spicy foods are often a popular choice, but can be a big problem if you suffer from heartburn. While it may be best to avoid spicy foods, you don’t have to settle for bland meals. There are always tasty alternatives to give you the flavourful taste you’re after, minus the burn.

Replacement: Try swapping the spices in your food with herbs like oregano, thyme, basil, and ginger. These spices add both flavour and nutrition to your meal, without the heartburn afterwards.

Citrus fruit, juices and fizzy drinks

Citrus fruit and fruit juices are common culprits for heartburn. Many soft drinks contain citric acid to help give them that tart flavour.

Replacement: Oranges, lemons, and tomatoes are highly acidic fruits. Swap out the acidic drinks for good old water. You can also add pieces of fruit to your water for taste Fruit like berries, apples, pears and bananas are less acidic than citrus fruit and can be good and healthy alternatives.

Garlic and onion

For many, the usual base of any meal starts with garlic and onions, however these are regular heartburn triggers.

Replacement: Dehydrated versions of garlic and onion are just as flavourful, but less acidic than their fresh counterparts.

Fried foods

Sometimes even looking at fried food can cause heartburn! Not really, but this is another common cause. Fat slows down the speed at which food leaves your stomach. That helps to keep you fuller for longer, but also means there is a greater chance of reflux

Replacement: Go with healthier cooking methods that include baking, grilling, poaching or roasting.

Heartburn medication

Antacids may be taken after meals, at bedtime, or when needed, to bind excess acid in the stomach and to coat the oesophagus. If you’re about to eat a meal that you know will cause heartburn, take one of these at least 30 minutes beforehand. You can get this over-the-counter medication from your local pharmacy or doctor.

References:

What is Gastroesophageal Reflux Disease (GERD)?

September 18th, 2018 by The Hello Doctor Team

Millions of adults suffer from heartburn. Although many of us brush off these symptoms as “nothing to worry about,” you may be at risk of GERD.

Gastroesophageal reflux disease (GERD) happens when the acid in your stomach frequently flows back into the tube, which connects your mouth and stomach (oesophagus). The backwash of the acid (acid reflux) irritates the lining of the oesophagus, causing different uncomfortable symptoms.

According to the American Gastroenterological Association, approximately 1 out of 3 people suffer from GERD and symptoms range from moderate to severe. Usually, GERD can be managed and treated with lifestyle changes and over-the-counter medication, but more severe cases will need treatment. This could be surgery and prescription medication.

Symptoms of GERD:

A burning sensation in your chest (heartburn), usually after eating fatty or oily foods, which might be worse at night.
Chest pain.
Difficulty swallowing.
Regurgitating food or liquids.
The sensation of a lump in your throat.
Abdominal pain.

How does it happen?

The sphincter is a circular band of muscle around the bottom of your oesophagus. When you eat food or drink liquids, it relaxes so that the food and drink can flow into your stomach. It then closes again. If the sphincter malfunctions, stomach acid can flow back up into the oesophagus, causing inflammation. GERD is caused because of the excessive acid reflux in the oesophagus.

Risk factors

Obesity
Pregnancy
Difficulty passing stools.
Bulging at the top of the stomach up into the diaphragm.
Eating a lot (especially fatty and fried foods) before bed.
Drinking alcohol and smoking excessively.

Managing GERD

Although the symptoms of GERD can be uncomfortable and in severe cases, painful, a few lifestyle changes will do you a world of good:

1) Take your time with food

Cut your food into bite-sized pieces and lay your fork down between bites. This will help you avoid eating too quickly.

2) Loosen up

If you feel pressure around your waist or abdomen, your clothes are too tight. Wear loose clothes that will not put pressure on your lower oesophageal sphincter.

3) Stick to a healthy weight

Excess weight places pressure on your abdomen and pushes your stomach up. This causes acid to rush up into your oesophagus.

4) Stub it out!

Excessive smoking causes your sphincter to malfunction.

5) Clean up your diet

Avoid foods and drinks that can trigger heartburn (acid indigestion). This may include garlic, onion, coffee, alcohol, chocolate and tomato sauce.

Treatment

Remember that only a doctor can diagnose and treat you properly for GERD. Treatment for GERD aims to manage or treat symptoms, prevent complications and heal a dysfunctional oesophagus. It may include medicine, surgery, lifestyle changes or a combination of treatments.

Medication could be over-the-counter drugs like antacid medication, which provides relief for moderate cases of GERD. Antacids neutralise your stomach acid which eases heartburn.

Talk to your doctor before using any medication. If your medication isn’t working and you need something stronger, your doctor will prescribe it. GERD prescription medication generally includes ones which will help limit acid secretion in your stomach.

If your GERD is severe, surgery can help strengthen the space between your stomach and oesophagus. You can’t make the choice to have surgery though, your doctor will advise it if needed, as most cases of GERD are manageable and treatable.

References:

Over-the-counter meds to get rid of heartburn

August 9th, 2018 by The Hello Doctor Team

You’ve just eaten a delicious meal. Instead of feeling satisfied though, you have that familiar uncomfortable sensation of heartburn. Ugh!

Heartburn, also known as pyrosis, is a burning feeling in your chest. It happens when stomach acid flows back up the oesophagus (the tube that carries food and fluids from the mouth to the stomach). This is usually because the sphincter (a band of muscle around the end of the oesophagus, that keeps it closed off) weakens, or doesn’t function properly. A bitter or sour taste in your throat or mouth is a common symptom when this happens.

Different lifestyle factors can cause heartburn. These include certain medications, being overweight, lying down after eating, spicy foods, tomato products, fried foods, alcohol, fizzy drinks or coffee. Despite its name, heartburn has nothing to do with the heart and is usually harmless.

Different over-the-counter medications can help manage heartburn symptoms.

These may include:

Antacids
H2 blockers.
Proton pump inhibitors (PPIs).
Combination antacids.

Heartburn medication you can get without a prescription

Antacids

Antacids help balance the amount of acid in your stomach to lessen heartburn, acid digestion and a sour stomach. Antacids may contain a substance called simethicone which helps your body get rid of gas. Common antacids include Alka-Seltzer, Milk of Magnesia, Gaviscon, Gelusil, Pepto-Bismol and Alternagel. Some of these antacids may contain ingredients that can cause constipation (e.g. aluminium), or diarrhoea (e.g. magnesium).Ask one of our doctor’s opinionsbefore trying antacids and if you do, follow the instructions on the label. Chewing this medication well before swallowing can help with faster heartburn relief.

Acid reducers

The job of this medication is to cut down the production of acid in the stomach. These include histamine antagonists (H2 blocker) and proton pump inhibitors. Examples include Axid AR, Pepcid AC, Zantac and Tagamet HB. Proton pump inhibitors are usually recommended if you experience heartburn two or more times per week. There are also stronger dosages available. Take these medicines according to the label’s instructions and talk to your doctor or pharmacist if you have any questions.

Combination antacids

This medication combines the acid-neutralising ability of antacids with an acid reducer (H2 blocker) to lessen symptoms of heartburn.

Good to know

Always read and follow the instructions on the label of OTC medication.
Don’t use medication for longer than the period on the label without talking to your doctor.
If you still feel heartburn symptoms or get worse after taking any of these OTC drugs, talk to your doctor as it may be something more serious like GERD(gastroesophageal reflux disease).
Avoid heartburn by avoiding foods that trigger heartburn (e.g. oily and spicy food), eating small meals instead of large ones, not lying down for two to three hours after you eat, losing some weight and quitting smoking.
If you experience dizziness, struggle to swallow or breathe, or have pain in other parts of your body along with heartburn symptoms, see your doctor immediately.

References

5 reasons you’re coughing constantly

June 18th, 2018 by The Hello Doctor Team

It’s annoying to sit next to someone who just keeps coughing. What’s worse, is when that someone is you. The coughing reflex has an important purpose, but what do you do when it doesn’t go away?

When you cough, you bring up mucous and harmful substances from your airways: it keeps your airways clear, so you can get oxygen into your lungs. You could also cough if you’re i’ll, and your lungs secrete mucous to get rid of the germs.

Most coughs only last for a few days or weeks and then you feel better, but when . If your cough lasts for eight weeks or more, we call it a ‘chronic cough’.

A normal cough shouldn’t cause too much discomfort, but a chronic cough can leave you feeling exhausted, cause you to vomit, feel lightheaded and even interrupt your sleep. A chronic cough usually has a hidden trigger and if it’s found, it can be treated.

Other symptoms that can accompany a chronic cough include:

A runny or stuffy nose
Liquid running down the back of your throat (postnasal drip)
Frequent throat clearing and a sore throat
A hoarse throat
Wheezing and shortness of breath
Heartburn or a sour taste in your mouth
In rare cases, coughing up blood

Coughing culprits

There are a few unexpected chronic coughing triggers. These include:

Postnasal drip

If your nose or sinuses make too much mucous, it can drip down the back of your throat. This condition is also called upper airway syndrome (UACS) and may trigger your cough reflex, causing chronic coughing.

Gastroesophageal reflux disease (GERD)

Your oesophagus is a tube that connects your stomach and throat. If you have GERD, stomach acid flows back into the tube. This causes a constant irritation which may lead to chronic coughing. This also makes the symptoms of GERD worse.

Asthma

In one type of asthma called cough variant asthma, coughing is the main symptom. Asthma-related coughs usually come and go with seasons and triggers, but because of the condition, the lining of the airway is swollen and inflamed. Air pollution, certain chemicals, being exposed to cold air, dust, pollen and stress are common triggers for asthma symptoms. Other symptoms include wheezing, tightness in the chest, and shortness of breath.

Heart failure

In some cases, the heart and coughing could be related. With heart failure, blood backs up in the pulmonary veins and fluid leaks into the lungs. The fluid build-up may cause chronic coughing and wheezing. The American Heart Association says that if you have a chronic cough, and symptoms like coughing up white or pink coloured mucous, nausea, shortness of breath, fatigue, light headedness, and a fast heartbeat, you should see a doctor.

Chronic bronchitis

Smoking-related illnesses are major culprits of chronic coughing. Chronic bronchitis causes inflammation in the major airways. A common symptom of this condition is chronic coughing that brings up colour fluids. Most people with this condition are current or past smokers. Besides chronic bronchitis, smokers can also develop “smoker’s cough” which is chronic, too. There are thousands of harmful chemicals in tobacco and when they’re released into the body, the body tries to remove them which can make you cough.

References

How to get a grip on heartburn

May 22nd, 2016 by The Hello Doctor Team

The ageing process has its positives and negatives: on one side, you know so much more than you knew a decade ago worry less about other’s opinions. On the other side, you have to deal with more health-related challenges, with heartburn as one of the most common complaints.

Continue reading “How to get a grip on heartburn”

Why do I have stomach pain?

March 23rd, 2015 by The Hello Doctor Team

Not again! Where is this pain in my stomach coming from? Do stomach cramps hit you when you least expect them? There are some obvious causes for stomach cramps, like the tummy bug or food poisoning, but what about unexpected causes? Here are 5 reasons that might be behind your mysterious pain. Continue reading “Why do I have stomach pain?”