See: What Else can we Attribute to GERD?
http://www.aboutgerd.org/gerdother.html
Some Seldom Discussed Complications of Gastroesophageal Reflux
By: W. Grant Thompson M.D., Emeritus Professor of Medicine, University
of Ottawa

Gastroesophageal reflux disease (GERD) means heartburn, possibly
without pronounced regurgitation of stomach contents and a feeling of
burning in the mouth.

Quotes from article:

" However, this article will deal with several seldom-described
consequences of GERD that are not rare and which can cause great
distress in their own right."

" Nocturnal Choking
Some people awake an hour or so after retiring with attacks of choking
and retching. Acid and sometimes food appear in the throat and there is
severe burning. Heartburn may or may not be present. Here again
late-night rich food and revelry may load the stomach, and the
reclining position during sleep sets the stage for food and acid to
reflux all the way to the throat. These attacks are distressing and the
burning throat may take hours to settle down"

" Aspiration Pneumonia
Debilitated or elderly patients may have reduced sensitivity in the
throat. This may reduce the usual anti-reflux defenses and permit some
individuals to breath in (aspirate) regurgitated material into their
lungs. The result is a chemical pneumonia quickly followed by infection
with opportunistic organisms. Patients with reduced consciousness are
very prone to aspirate, but in ambulatory persons it is rare.
Aspiration pneumonia may be difficult to treat because of the unusual
organisms that invade the damaged lungs, and continued aspiration may
occur if the condition is unrecognized"

" Asthma
There is an interesting relationship between non-allergic
(non-seasonal) asthma and gastroesophageal reflux. Respiratory symptoms
such as coughing or wheezing produce reflux by sudden, violent changes
in the intra-abdominal and intra-thoracic pressures. Reflux also may
occur during the deep inhalation taken before forceful exhalation by an
asthmatic. Conversely, acid reflux irritates the larynx and may cause a
reflex constriction of the bronchi."

" Acid Laryngitis
Occasionally, gastric juice may reflux through the esophagus and upper
esophageal sphincter and spill into the larynx, or voice box. The
ensuing inflammation of the posterior larynx causes laryngitis and
hoarseness. Acid may be detected in the larynx in some reflux episodes,
and damage to the larynx is sometimes visible through a scope.
Diagnosis may be difficult. There may be no heartburn to warn the
individual of a reflux episode. Just as the esophagus may look normal
in a person with heartburn, so laryngitis may occur with a normal
appearing larynx.

Symptoms include hoarseness, persistent nonproductive cough, and a need
to continually clear the throat. Some individuals feel that something
is stuck in the throat."

" Reflux Dyspareunia
In a study of 100 Glasgow women, 77 reported having heartburn during
intercourse. This phenomenon may be more common than publicly admitted.
Clearly the recumbent position on a full stomach is ill advised. The
Scottish researchers recommended weight loss, avoidance of stooping,
and the "female-superior position" which they claim improved 61 of
their 77 subjects."

Caution about medications:

" While acid reducing drugs such as the H2 blocking agents (e.g.,
ranitidine, famotidine, cimetidine, nizatidine) and proton pump
inhibitors (e.g., omeprazole, lansoprazole, rabeprazole, pantoprazole)
are helpful, they only reduce the acidity of the refluxed material.
Other refluxed substances may also cause many of the conditions
described above. The importance of letting a meal digest and move out
of the stomach before retiring cannot be overemphasized."

Regards,  Richard Friedel

"

"