Dr. Starpoli's Blog

Silent Acid Reflux

Posted by Rachel Jones on Feb 20, 2014 9:44:00 AM

Silent acid reflux, also known as Laryngopharngeal Reflux or LPR, is a condition that you could be suffering from without even knowing it, and can have many negative impacts on health. Similar in many ways to Gastroesophageal Reflux Disease (better known as GERD), there are a few critical differences that can make silent reflux very difficult to treat, and even harder to diagnose. 

As opposed to traditional GERD, silent acid reflux may not present itself with symptoms normally associated with the condition. Normally reflux disease causes a burning sensation in the chest or throat, as well as the stomach. LPR is called silent reflux because often it does not cause these same problems, but can cause a number of other symptoms--including, but not limited to:

  • Chronic couging or hoarseness 
  • Asthma or breathing problems
  • Sleep apnea
  • Constant need to clear the throat
  • Excess mucus build up

Caused by a weakness in the muscles between the esophagus and the stomach, silent reflux can have many negative long and short term implications such as recurring ear infections, ulcers in the stomach and throat, scarring of the throat and voice box, in addition to very serious conditions like emphysema and cancer. 

It takes a very skilled Gastroenterologist to diagnose silent acid reflux--if you suspect you may have the condition, it is important to consult a Physician immediately.

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Anthony A. Starpoli, MD | www.starpoli.com

atypical reflux, nonacid reflux, starpoli, symptoms

Refluxology: The Study of GERD

Posted by Anthony Starpoli on Jul 21, 2012 11:36:00 AM

So, you think you have acid reflux?  What is acid reflux?  Why is it called acid reflux?

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Anthony A. Starpoli, MD | www.starpoli.com

Obesity, GERD, atypical reflux, nonacid reflux, heartburn, EsophyX, incisionless surgery, Barrett's Esophagus

Dental Detriments of GERD

Posted by Anthony Starpoli on Mar 13, 2012 2:35:00 AM

A six-month follow up of 12 people with GERD and six others who were not suffering from the condition showed that those with acid reflux had much worse tooth wear and erosion. 

Tooth erosion may naturally occur due to chewing but about half of GERD patients had tooth wear and erosion several times higher than the healthy counterparts, says the report inJournal of the American Dental Association

The acid from the stomach is strong enough “to dissolve the tooth surface directly, or soften the tooth surface, which is later worn down layer by layer,” said lead author Dr. Daranee Tantbirojn of the University of Tennessee. 

“The damage from acid reflux looks like tooth wear -- the tooth is flattened, thin, sharp or has a crater or cupping.” 

Saliva acts as a defense mechanism because its buffering capacity helps protecting teeth in neutralizing acid, but it cannot fully protect teeth against all acid condition in mouth formed after eating and drinking or due to acid reflux from stomach. 

Researchers suggested people with acid reflux to follow some measures to lower their teeth damage. They, for instance, should avoid brushing their teeth immediately after an acid reflux episode and use a fluoride rinse instead. 

Using Xylitol chewing gum and taking baking soda or antacids after acid reflux episodes can also protect teeth against erosion. 

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, GERD, atypical reflux, nonacid reflux

Much Greater Risk for Clostridium difficle with Reflux Therapy

Posted by Anthony Starpoli on Oct 7, 2011 6:47:00 PM

In a retrospective study from Japan, the chronic use of proton pump inhibitors (PPIs), often used in the treatment of GERD, was found to be associated with a greater than 3-fold increased risk of developing Clostridium difficile–associated diarrhea (CDAD), Takatoshi Kitazawa, MD, assistant professor at Teikyo University in Tokyo, Japan, reported during a poster session at the 51st Interscience Conference on Antimicrobial Agents and Chemotherapy.

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, diarrhea, TIF, GERD, nonacid reflux, EsophyX

Antireflux Surgery and GERD Drug Therapy Achieve Similar Results

Posted by Anthony Starpoli on Jun 4, 2011 11:43:00 AM

A report was published in the May 18 issue ofA report was published in the May 18 issue of Journal of the American Medical Association. In, what is referred to as the LOTUS (Long-Term Usage of Esomeprazole vs Surgery for Treatment of Chronic GERD) study, remission rates at five years were 92% (95% CI 89 to 96) for patients on esomeprazole and 85% (95% CI 81 to 90, P=0.048) for those who had laparoscopic antireflux surgery, according to Jean-Paul Galmiche, MD, of Nantes University in France, and colleagues. 

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, TIF, fundoplication, GERD, nonacid reflux, EsophyX

GERD Affects Sleep and Next-Day Performance

Posted by Anthony Starpoli on Oct 23, 2010 9:36:00 AM

Gastroesophageal Reflux Disease or GERD is well-known to affect sleep patterns and an irregular sleep pattern can lead to poor performance in wake periods. Furthermore, there is a bidirectional relationship between sleep and GERD.  Poor sleep can lead to an exacerbation of GERD and GERD can disturb sleep.

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, sleep disturbance, insomnia, GERD, atypical reflux, nonacid reflux

The Not So Common Forms of Reflux

Posted by Anthony Starpoli on Oct 14, 2010 10:50:00 AM

Most people think of gastroesophageal reflux disease or GERD as the classic symptoms of heartburn or regurgitation.  Heartburn is often reported as a burning sensation below the breast bone and regurgitation is the effortless repeating or return of food material back up the esophagus (or food tube).  It is important not to mistake a chest pain complaint that may be cardiac in origin for reflux.  See your doctor if you have a new chest pain complaint, especially if you have cardiac disease risk factors such as a family history of heart disease, high cholesterol, obesity, or if you smoke.  Now, back to reflux troubles.

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Anthony A. Starpoli, MD | www.starpoli.com

Reflux, cough, GERD, atypical reflux, nonacid reflux