Hi XXXXXX,

Thanks for posting your query.

1) As you have already mentioned you are a known case of GERD & asthma, there may be possibility of allergic rhinitis with post nasal drip (symptoms mentioned by you) with overlying secondary bacterial infection. There may also be possibility of recurrent throat irritation by reflux acid.

2) Kindly mention the following details:
a) Have you sour liquid in mouth? This is called as "water brash" in medical language.
b) Have you any fever episodes? This indicates some sort of infection.
c) Have you abdominal heaviness with bloating sensation?
d) Are you using tiotropium/ Ipratropium inhaler for asthma? This may cause dryness of your throat and recurrent irritation and clearing of your throat.
e) Which medicine you are using for asthma & GERD?

3) You should go for ENT surgeon and physician opinion.

4) You should go for Mucous culture & sensitivity, Antacid and Anti-GERD treatment.

5) You should take PPI twice in a day with prokinetics on written prescription. This therapy will reduce your throat irritation with relief.

6) You should also take Anti allergic medicine such as cetrizine/ levo cetrizine with montelukast on written prescription.

7) You should also perform 3 times gargles. Add a pinch of salt in a full glass of lukewarm water for gargling.

Put your query if you have.

Best regards,

Dr. Mayank Bhargava

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Hi XXXXXX,
Thanks for sharing your details.
1) Presence of abdominal distension showed abdominal problems are the culprit cause of your problem.
2) Advair and Proair doesn't contain Tiotropium/ Ipratropium and you can continue these medications if you are not feeling breathlessness.
3) Pepcid contains Famotidine which is a H2 antagonist while PPI (proton pump inhibitors such as Pantaprozole/ rabeprazole/ esomprazole/ omeprazole) are more effective as compared to H2 antagonists.
4) Prokinetics (Itopride/ cinitapride/ levosulpride) are the medicine which will help i propulsion of food ahead and keep your stomach empty and relief of GERD symptoms.
5) You should take combination of PPI & prokinetics.
6) You should also take dietary precautions:
a) Avoid tomato, citrus fruits, tea, coffee, chocolates, onion, garlic, oily and
spicy food.
b) You should keep 3 hours difference between meals and sleep.
c) Avoid tight cloths.
d) Avoid legumes.
e) Take Yogurt and soft diet.
f) Take small amount and frequent foods
7) If your asthmatic symptoms are controlled by inhalational therapy, then there is no need of oral medicine for allergy as these medicine are distributed to all organs of the body while medicine by inhalers are exposed to lungs onle
Take care,
Dr. Mayank Bhargava

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