New Reflux Disease

11/28/2008 CHARLESTON, S.C. Two years ago, Sylvia Gustafson's life changed forever. While working as a nurse at a hospital, a patient strangled her.

"I lost my voice within the house," Gustafson told Ivanhoe.

The massive throat injury damaged her esophagus, lungs and vocal cords. Her voice is now a whisper, amplified by a voice box.

"I still feel grateful that I still got a little voice," Gustafson said.

She also started having asthma symptoms. Donald Castell, M.D., a gastroenterologist at the Medical University of South Carolina in Charleston, S.C., is seeing these unusual symptoms in people on medication for acid reflux disease.

"It's a phenomenon that's occurred because of all the drugs that are out there now that control acid so well," Dr. Castell told Ivanhoe. "They'll stop the acid, but they don't stop the reflux."

It's called non-acid reflux -- it can cause chronic cough, asthma, indigestion and nausea -- symptoms not typically linked with acid reflux disease.

"If we can detect it, then we're going to have a much better chance of treating it," Dr. Castell explained.

Typical monitors depend on acid as a signal to detect acid reflux disease. Now, this new monitor can detect reflux when there's no acid present by measuring electrical resistance in the esophagus.

"It's a huge step forward," Dr. Castell remarked. "We've been pleased and so have the patients."

When patients learn reflux is the problem, they can have surgery to fix it.

Dr. Castell thought non-acid reflux might be causing Gustafson's asthma symptoms. She wore the new monitor for 24 hours.

"It showed 144 reflux episodes, and the normal is below 40," Gustafson proclaimed.

She had surgery and her reflux is gone. She's still fighting her way back to a normal life, but she's optimistic.

"I think you need to be just thankful for what you have," she said.

In one study, non-acid reflux disease was found to be the culprit in 26 percent of patients who had chronic cough. Once it's found, doctors say treatment works. In another study, every one of the patients with chronic cough caused by reflux was cured of that cough after surgery.

Kathleen Ellis
The Medical University of South Carolina
Charleston, SC


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