Patient education

ANIMAL AVOIDANCE

Cats

Removal of cats from the home is the only method of reducing cat allergen. However, after removing the cat it takes 6 to 12 months to eliminate the allergen. In trying to control cat allergen with a cat present in a house, there are two issues: the reservoirs (carpets, sofas, etc.) and the cat itself. Washing the cat and aggressive measures to reduce reservoirs (i.e. removing carpets), air filtration, and vacuuming with a HEPA-filter, sometimes help to reduce cat allergen levels.

In summary, pets can cause direct and indirect allergic problems, both from the dander, saliva, and from pollen accumulated on the fur. Allergic children and adults should not pet, hug, or kiss their pets, because of the allergens on the animal's fur or saliva. Those pets that are known to cause allergic reactions should be removed from the home of the allergic patient. If the family is unwilling to do this, the pet should be kept out of the patient's bedroom and, if possible, outdoors.

GERD

PREVENTION:

People with GERD should first try lifestyle and dietary changes. In one study, 44% of patients who experienced symptoms of GERD reported improvement after changing their diet. Some suggestions are: avoid or reduce consumption of foods and beverages that contain caffeine, chocolate, peppermint, spearmint, and alcohol. Both caffeinated and decaffeinated coffee increase acid secretion. All carbonated drinks increase the symptoms of GERD.

LIFESTYLE CHANGES:

Weight Reduction: Obesity increases pressure on the abdomen and stomach which can increase pressure on the lower esophageal sphincter and cause reflux. Smoking: Smoking increases GERD symptoms. It decreases lower esophageal pressure and increases salivary secretion.

Fatty Foods: The relationship between dietary fat and GERD is unclear. Dietary fat is thought to delay emptying of stomach. Reducing dietary fat is important for health in general and part of an overall strategy to reduce GERD symptoms.

Irritating Foods/Beverages: Foods that might aggravate GERD include: tomatoes, garlic, onions, chocolate, peppermint, coffee and citrus fruits. Reactions vary considerably. Monitor reactions to specific foods.

Meal Size & Frequency: Avoid eating large meals which can stimulate sensors that affect lower esophageal sphincter relaxation. Eat smaller meals more frequently, perhaps 4 or 5 times daily. Do not eat for at least 2 or 3 hours before bedtime.

Upper Body Elevation: Use gravity to help keep stomach contents out of the esophagus. Elevate the upper portion of the body including the head, at least six inches by raising the head of the bed frame with telephone books, foam, or wood blocks. Do not raise the head only, as it may increase pressure on the stomach. Elevate the entire upper body throughout the night; this can produce remarkable relief for GERD sufferers. Also try to lie on the right side to exert less pressure on the esophageal sphincter.

Limit Aspirin, Ibuprofen, and other NSAID's: Non-steroidal anti-inflammatory drugs inhibit formation of prostaglandins, thus promoting reflux. Prostaglandins inhibit gastric secretions and stimulate mucus secretion and minimize effects of acid reflux.

Avoid Chewing Gum & Hard Candy: Chewing gum and hard candy increase the amount of swallowed air and can lead to belching and reflux.

MEDICATIONS:

Antacids, H2 blockers, proton pump inhibitors.

 

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