Practical SLP Info© - from Texas Health Care, Fort Worth
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Reflux FAQ

 

How do I take my medication?

In this practice, there are two different types of medications commonly used for reflux management. Identifying which medication you have been prescribed is important in determining how to take the medicine. First, find your medication on the lists below, then follow the instructions provided. We always advise you to ask your pharmacist about any specific questions you may have in this regard.

Commonly Prescribed PPIs:
  • Nexium
  • Kapidex
  • Prilosec (omeprazole)
  • Prevacid (lansoprazole)
  • Protonix (pantoprazole)
  • AciPhex
  • Zegerid

Commonly Prescribed H2 Blockers:
  • Tagamet (cimetidine)
  • Pepcid, Pepcid AC (famotidine)
  • Axid, Axid AR (nizatidine)
  • Zantac (ranitidine)

TAKING A PPI:

PPIs are much less effective in shutting off the acid pumps when they are taken improperly. It is very important to take this medication properly in order to ensure its maximum effectiveness.
  • Once daily:
All PPIs should be taken first thing in the morning, with just a glass of water. Allow at least 30-45 minutes to pass before eating or drinking anything. Other medications may be taken simultaneously, although this should be discussed with your doctor or pharmacist first.
  • Twice daily:
If you are prescribed a twice daily dose, the first dose should be taken first thing in the morning, with just a glass of water. Allow at least 30-45 minutes to pass before eating or drinking anything. For the second dose, it is important you have an empty stomach before taking.

There are two options for the second dose:
Option 1: do not eat/drink anything besides water for three hours (allowing your stomach to empty). This can be done by not snacking in the afternoon for a period of three hours, take the medication, then wait 30-45 min before having dinner.
Option 2: Have dinner, wait three hours, then take with just water before bed. You should not have anything besides water to eat or drink following this dose.

Taking an H2 Blocker:

This medication should be taken with a glass of water, 30 minutes before dinner.

How long to I have to follow the Reflux Diet?

In this practice, an initial diagnosis of reflux laryngitis will typically involve medical management to include both dietary/lifestyle modifications as well as medication. Although the medications prescribed may only be used for a short period of time, the dietary and lifestyle modifications will be helpful to use throughout your life.

My Barium Swallow exam showed I did not have reflux so why am I still being treated for it?

The barium swallow examination is very helpful in determining the presence of anatomical or functional problems that may be contributing to your suspected reflux.

If however, no reflux is documented during this examination, it does not mean you do not experience reflux at other times, with different stomach contents. Barium is very heavy, in fact it is heavier/more dense than most foods we eat. For this reason, it may not “behave” the same as the normal foods you eat. In addition, this examination is a small, typically, <5 min window into the activity of your upper GI tract. Not observing reflux during this examination does not necessarily correspond to what happens during the course of a full day. Your doctor will advise you on the potential need for further testing.

I never have heartburn so how can I have reflux?

Although heartburn is the most commonly associated symptom of reflux, it is possible to experience very characteristic, although lesser known reflux symptoms. For this reason, many patients may deny they are experiencing reflux.  Here are some other common symptoms:
  • painful swallowing
  • sore throat (especially worse in the morning)
  • hoarseness
  • laryngitis
  • “lump in the throat” sensation
  • frequent coughing
  • sour/foul taste
  • halitosis (bad breath)
  • feeling of food sticking when swallowing
  • difficulty swallowing
  • frequent belching/burning
  • indigestion
  • waking up coughing

You may experience only one of these symptoms, or several simultaneously. You may also notice symptoms are worse at times, then improve for a period of time, only to return again. It is important to discuss this with your doctor if you experience any of these symptoms one or more times per week.

It is also possible to be experiencing reflux without the presence of any notable symptoms. In this practice, there are characteristic changes in the throat that signal the likely presence of laryngopharyngeal reflux. After an endoscopic examination of your throat, you may be informed of the potential for some notable changes to be caused by reflux even without having any usual symptoms. As reflux can lead to potentially serious health effects, your doctor will likely choose to treat your reflux, even if you have no complaints in this regard. Further testing will be arranged to determine if reflux is contributing to the examination findings as well as determine how significant a reflux issue you may have.

Copyright 2011-2013 Katrina M. Jensen, M.A., CCC-SLP, PLLC