HealthWatch: Allergies, Asthma or Acid Reflux?


 Do you feel congested or struggle with a scratchy, hoarse throat? Your troubles might not be in your lungs. Medical experts are starting to look to the stomach as the culprit. 
Susan Howard is a registered nurse and volunteer teacher who gradually started having trouble in front of a large class.
Howard said, “I’d lose my voice and say just bear with me. I do this.” 
Lisa Smelkinson’s symptoms appeared suddenly and they were tough to ignore. 
“I remember distinctly having lunch with a friend and coming home and coughing to the point of almost vomiting,” Smelkinson said.
Both women were treated for months for what doctors thought were colds, allergies, or asthma until they visited Jamie Koufman, MD, FACS, Director, Voice Institute of NY, Clinical Professor of Otolaryngology at the New York Eye & Ear Infirmary of the Mt. Sinai Medical System.
“The problem with the idea that it’s asthma or a cold is that the symptoms don’t go away. Even after the asthma is treated they continue to have symptoms,” Dr. Koufman stated.
Dr. Koufman says with silent reflux neither the lower valve or upper valve is working right.
She continued, “So what’s in the stomach is in the esophagus, is in the throat, and it sits there at night.” 
Dr. Koufman says if you have trouble breathing in but not out, the problem could be reflux. She says the number one risk factor is eating too much right before bed. Sleep on a 45-degree incline, leave four hours between your last meal and bed, and avoid junk food, soda and chocolate milk. 
“No physician ever said to me it’s dietary-related,” Smelkinson said.
“I tell them you won’t need me in a year,” Dr. Koufman told Ivanhoe.
For many patients, lifestyle changes help make this the last stop in a long search for better health.  
Both Smelkinson and Howard say their symptoms have significantly decreased since they made dietary changes. Dr. Koufman says for some patients, certain medications called H2 antagonists like Pepcid, or Zantac are also safe and effective.
Contributors to this news report include: Cyndy McGrath, Field and Supervising Producer; Hayley Hudson, Assistant Producer; Kirk Manson, Videographer; Dave Harrison, Editor.

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REPORT:    MB #4465 

BACKGROUND: Itchy, watery eyes and chronic cough have long been associated with allergies or asthma; however, new research suggests that these common conditions are in fact being misdiagnosed.  They may be a type of acid reflux known as silent reflux. Silent reflux (laryngopharyngeal reflux) unlike GERD (acid reflux) does not show customary signs of GERD such as: belching, heartburn and nausea.  A few laryngopharyngeal reflux indicators are: hoarseness, chronic cough, noisy breathing and trouble feeding just to name a few. Silent reflux is something to be cognizant of if your common allergy, cold or asthma symptoms don’t seem to vanish or respond to antihistamines or cold medicines. 
(Sources: &

DIAGNOSIS: Diagnosis for silent reflux is generally fairly as simple as detecting if there is irritation or swelling in the throat, specifically the back part of the voice box. Further testing is seldom needed beyond this; however, sometimes the following tests are conducted: a PH Test, which measures the level of acidity in the throat, a swallowing test, in which a liquid coats the esophagus, stomach and intestines to make them visible in an X-ray, or a direct examination of the stomach and esophagus with a scope.  

NEW DEVELOPMENTS/TREATMENTS:  A diet change is recommended by most doctors when developing treatment options for patients. One doctor suggests a two-week elimination diet in which acid-forming and hard to digest foods are eliminated or curtailed; foods such as: alcohol, coffee, spicy foods and dairy. Experts recommend a patient adopt a low-fat, low-acid diet. This modified diet should reduce symptoms and with long term implementation should p keep silent reflux at bay. 


Alex Kofsky

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know~to seek or change treatments, please let us know by contacting Marjorie Bekaert Thomas at

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