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Dr. Andrew Rynne
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Dr. Andrew Rynne

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What causes extraesophageal reflux disease?

Answered by
Dr.
Dr. Nishad BN

General & Family Physician

Practicing since :2009

Answered : 5222 Questions

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Posted on Tue, 23 Aug 2016 in Medicines and Side Effects
Question: Hi,
i have issue issue with respiration from last few weeks. i get such issue when the temp. drops (climate change). I have choking sensation while breathing from last few weeks. I have dust allergy and bit of respiration issue. When ever i have choking issue i use Seroflo 250. it gives me relief with in few min.

Previously i used to take seroflo once in a while that too in cold climate. but from last few days i m forced to take it daily because i feel choked by evening and if i dont take the medicine i cant sleep because of the irritation. Daily morning i can see quite a bit of cough come out (light yellowish) and i have to struggle a lot to take it out. while coughing it feel like the cough is stuck some were near the check and thus it irritates a lot in morning.
doctor
Answered by Dr. Nishad BN 2 hours later
Brief Answer:
Laryngopharyngeal reflux also can be present.

Detailed Answer:
Hi

Thank you for asking HCM.

I have gone through your query. The reason of your breathing problem from allergy can be due to internal and external source. Laryngopharyngeal reflux can also be present in your case. This usually gives the chocking sensation.

In this case I usually suggest proton pump inhibitors like esomeprazole ( Nexium ) for long term. This will decrease the irritation on throat and avoid allergic reaction from it.
I also suggest to take combination of anti histamines like levocetirizine and mast cell stabilzers like monteleukast for long term. This will be helpful as a prophylactic from getting attacks of asthma.

If yellowish phlegm is there then bacterial infection can be present and you need antibiotic therapy. I would suggest antibiotics like Azithromycin or Co-amoxiclav in such case. If there is breathing difficulty you can continue seroflo till it subside.

Let me know if anything not clear.
I am happy to help you.
Thanks.
Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
doctor
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Follow up: Dr. Nishad BN 6 hours later
Hi Dr. XXXXXXX

Thanks for your review and comments.
Had few queries regd the same.
1. Laryngopharyngeal reflux -
a. How is it caused?
b. Any food habits that affect or influence it?
c. Can this be avoided by home remedies?
2. Proton pump inhibitors like esomeprazole ( Nexium ) - Recommended Dosage.
3. Anti histamines like levocetirizine and mast cell stabilizers like monteleukast -
a. Is this a combination drug.
b. Recommended Dosage.
4. Azithromycin or Co-amoxiclav - Recommended Dosage.

Can you tell me what will be the side effects for Sl.No 2# & 3# in long run.
doctor
Answered by Dr. Nishad BN 9 hours later
Brief Answer:
Laryngopharyngeal reflux

Detailed Answer:
Welcome again

Thank you for your follow up q8ery.

1. Laryngopharyngeal reflux is retrograde flow of gastric acid or contents. Most of them don't even feel it but only will have throat irritation or respiratory problems. This can be caused by long standing gastric irritation or reflux.
Taking spicy fatty fried and junk foods , carbonated drinks, alcohol , smoking , drinking excess coffee have influence on it.
By avoiding these you can decrease it. Also have dinner 2 hours before bed time. Raise the head end more with adequate pillows. These measures helps. Drinking Ginger tea , chamomile tea and honey helps also.
2. Usual dose I recommend for esomerazole is 40mg once daily 1 hour before breakfast.
3. Levocetirizine and Monteleukast is a combination drug come in fixed dosage. This is available in brands like montek LC ,L montair etc. It is given once daily at bed time. It is a prescription drug.
4. Azithromycin usual dosage given is 500mg once daily for 3 to 5 days according to severity. Co-amoxiclav is given 625mg twice daily for 5 days. These are prescription antibiotics.

2 and 3 if tolerated well. Side effects are very rare. Levocetirizine can cause tiredness in some. Esomeprazole - very rarely some experience muscle weakness and cramps.
When considering the benefits side effects are very less and can be discarded.

Let me know if anything not clear.
I am happy to help you.
Thanks.
Above answer was peer-reviewed by : Dr. Raju A.T
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