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GERD Reflux esophagitis or GERD is very common. Daily we will see patients with hoarseness, throat pain or cough who ultimately have reflux to blame. Diagnosis requires visualization of the larynx and findings of thickening of the posterior larynx due to this regurgitation of acid. This is called Pachyderma, since it is very thick, like elephant skin. At times, flexible laryngoscopy is performed with video documentation in order to see the larynx, especially with excessive gagging. Treatment require dietary changes and weight loss, nocturnal positional changes and often medication. Head of bed elevation with pillows is not enough. Pillow wedges or true elevation of the bed posts on a 2 by 4 will help. A hospital bed is great. Eating earlier and allowing 3-4 hours before supine position is necessary. Medication includes OTC Zantac, Axid, Tagamet as well as Mylanta II and Tums. Stronger treatment might include Nexium, Previcid or Protonics.
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