AAOSH’s stated purpose is “Connecting Medicine and Dentistry to Save Lives.” Gastric reflux, obstructive sleep apnea, and diet illustrate both oral and whole body connections that have life-altering implications.
There are several common risk factors for gastric reflux including hiatal hernia, overeating, eating too late at night, obesity, smoking, stress, obstructive sleep apnea (OSA) and an unhealthy diet.
Let’s discuss the latter two in more detail.
While OSA may be associated with an increased incidence in gastric reflux it is also apparent that gastric reflux can produce esophageal and airway inflammation, spasms of the vocal cords, compromise the airway and possibly stimulate OSA. These two disorders often occur in tandem, leading to a chicken and egg question of which causes the other.
The typical western diet is very acidic. Sports drinks, sodas, canned foods, citrus, caffeine and all sources with a pH< 4 can activate pepsin molecules attached to the walls lining the esophagus and airway. Pepsin will damage the surrounding tissue causing irritation, inflammation and swelling. Acid suppressant medications are often insufficient. Effective treatment requires a change of diet, eliminating acidic foods, drinks and fried foods, with no eating after 8:00 p.m.
50,000 patients completed an online survey, conducted by Dr. Koufman, asking, “Think you might have reflux? Which symptoms do you have?”
These common responses followed:
Gastric reflux screening should cover the common symptoms. Patients with “Silent Reflux” report none of the above symptoms. If signs are present, such as tooth biocorrosion, consider a referral to an experienced otolaryngologist or gastroenterologist.
When signs and symptoms of gastric reflux are present, include two important considerations:
It is essential to dig deeper into our patients’ health histories and symptoms in order to fully understand the full extent of the problem. Making the important connections between lifestyle factors, clinical presentation, and seemingly unrelated symptoms is what we in the AAOSH community do best—and our persistent focus on treating the whole patient will continue to improve and save our patients’ lives.