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Laryngopharyngeal reflux (LPR) or laryngopharyngeal reflux disease (LPRD) is the retrograde flow of gastric contents into the larynx, oropharynx and/or the nasopharynx. [4] [5] LPR causes respiratory symptoms such as cough and wheezing [6] and is often associated with head and neck complaints such as dysphonia, globus pharyngis, and dysphagia. [7]
Normally, histamine acts on H 2 to stimulate acid secretion; drugs that inhibit H 2 signaling thus reduce the secretion of gastric acid. H 2-antihistamines are among first-line therapy to treat gastrointestinal conditions including peptic ulcers and gastroesophageal reflux disease. Some formulations are available over the counter.
The H 2 receptor antagonists are a class of drugs used to block the action of histamine on parietal cells in the stomach, decreasing the production of acid by these cells. H 2 antagonists are used in the treatment of dyspepsia, although they have been surpassed in popularity by the more effective [1] proton pump inhibitors.
In gastroenterology, esophageal pH monitoring is the current gold standard for diagnosis of gastroesophageal reflux disease (GERD). It provides direct physiologic measurement of acid in the esophagus and is the most objective method to document reflux disease, assess the severity of the disease and monitor the response of the disease to medical or surgical treatment.
Allergy blood tests are very safe since the person is not exposed to any allergens during the testing procedure. After the onset of anaphylaxis or a severe allergic reaction, guidelines recommend emergency departments obtain a time-sensitive blood test to determine blood tryptase levels and assess for mast cell activation. [117]
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In some cases, a person with GERD symptoms can manage them by taking over-the-counter drugs. [50] [51] [52] This is often safer and less expensive than taking prescription drugs. [50] Some guidelines recommend trying to treat symptoms with an H 2 antagonist before using a proton-pump inhibitor because of cost and safety concerns. [50]
The role of H. pylori in functional dyspepsia is controversial, and treatment for H. pylori may not lead to complete improvement of a patient's dyspepsia. [6] However, a recent systemic review and meta-analysis of 29 studies published in 2022 suggests that successful treatment of H. pylori modestly improves indigestion symptoms.