President Barack Obama was in a hospital Saturday after having symptoms of a sore throat, but doctors later determined it was acid reflux.
The trip was unscheduled for President Obama, according to The Inquisitr. The press pool, journalists who typically follow the president, had initially been dismissed for the day. White House Press Secretary Josh Earnest said Dr. Jackson, the president’s physician, recommended Obama go to Walter Reed Medical Center in Washington for diagnostic tests.
“According to Dr. Jackson, the test is a matter of convenience for the President, not a matter of urgency.”
Acid reflux is a chronic symptom of mucosal damage caused by stomach acid building up from the stomach into the esophagus. Treatment typically begins with a lifestyle change and medications such as proton pump inhibitors, H2 receptor blockers or antacids with or without alginic acid. Surgery may be an option in those who do not improve. In the Western world between 10 and 20 percent of the population is affected.
While Obama was in the hospital, Dr. Jackson kept everyone up to date on tests. He said that an ear, nose and throat specialist form Fort Belvoir Medical Center conducted a fiber optic exam. The exam revealed soft tissue swelling in the posterior throat.
“I, in consultation with the specialist, determined that further evaluation with a routine CT scan was prudent. The CT scan was conducted this afternoon purely as a matter of convenience for the President’s schedule. The CT scan was normal. The President’s symptoms are consistent with soft tissue inflammation related to acid reflux and will be treated accordingly.”
The diagnosis of acid reflux is usually made when typical symptoms are present. Reflux can be present in people without symptoms and the diagnosis requires both symptoms or complications and reflux of stomach content, according to the Examiner. This is why Obama was in a hospital immediately, suggested by Dr. Jackson.
Other investigations may include esophagogastroduodenoscopy (EGD). Barium swallow X-rays should not be used for diagnosis in a hospital. Esophageal manometry is not recommended for use in diagnosis being recommended only prior to surgery, which is what they did with Obama. Ambulatory esophageal pH monitoring may be useful in those who do not improve after PPIs and is not needed in those in whom Barrett’s esophagus is seen.
The current gold standard for diagnosis of acid reflux is esophageal pH monitoring. It is the most objective test to diagnose the reflux disease and allows monitoring patients in their response to medical or surgical treatment. One practice for diagnosis is a short-term treatment with proton-pump inhibitors, with improvement in symptoms suggesting a positive diagnosis.
This also means that President Obama will have to stay away from certain foods and a lifestyle change will be in order to promote gastroesophageal reflux. Elevating the head of the bed are generally useful. Moderate exercise improves symptoms, however in those with vigorous exercise may worsen them.
Doctors say that smoking can sometimes cause this disease, but Obama quit that habit a few years before going into the hospital. The biggest thing is avoidance of specific foods and of eating before lying down. Foods that have been implicated include coffee, alcohol, chocolate, fatty foods, acidic foods, and spicy foods.
Obama was prescribed Proton-pump inhibitors (PPIs) (such as omeprazole), which are the most effective followed by H2 receptor blockers. If a once daily PPI is only partially effective they may be used twice a day. They should be taken one half to one hour before a meal.
There is no significant difference between agents in this class. When these medications are used long term, the lowest effective dose should be taken. They may also be taken only when symptoms occur in those with frequent problems. H2 receptor blockers lead to roughly a 40% improvement, which were used while Obama was in the hospital.
The evidence for antacids is weaker with a benefit of about 10 percent while a combination of an antacid and alginic acid (such as Gaviscon) may improve symptoms 60 percent. Metoclopramide (a prokinetic) is not recommended either alone or in combination with other treatments due to concerns around adverse effects.
Sucralfate has a similar effectiveness to H2 receptor blockers; however, sucralfate needs to be taken multiple times a day, thus limiting its use. Baclofen, an agonist of the GABAB receptor, while effective, has similar issues of needing frequent dosing in addition to greater adverse effects compared to other medications.
The “Obama in hospital” story worried a lot of people because they didn’t know why the President was sick, notes ABC News. The press was told that he had a sore throat, but his doctor did a great job informing the public of tests and the outcome from procedures. Obama is actually in good shape, so his physician expects him to fully recover with certain changes to diet and lifestyle.