It has been estimated that as many as 30% of people have a hiatal hernia or malfunctioning lower esophageal sphincter (LES). The LES is a muscular “valve” that is supposed to keep highly acidic stomach contents from going backward into the esophagus. Persons wish one of these conditions might note frequent heartburn or acid belching. However not everyone has these obvious symptoms. 

When a person with acid reflux lies down at night, acid may travel up to the level of the throat and even come into contact with parts of the larynx. Because this occurs mainly at night during sleep, the person is often unaware that this is happening.

One or many of the following may symptoms may result: 

  • Chronic sore throat: usually worse in the morning and gets better as the day progresses. 
  • Excessive morning “phlegm” 
  • Chronic, irritative cough 
  • A sensation of needing to continually clear one’s throat 
  • A particularly low or husky voice in the morning requiring prolonged “warm-up” if one is a singer. 



1. Avoid caffeine (soda, coffee, tea, chocolates) alcohol, spicy foods, cigarette smoking, fatty foods, and mints. These substances may increase stomach acidity and may also make the LES function poorly. Use decaffeinated drinks. 

2. Eat the last meal/snack of the day no fewer than 4 hours before going to sleep. In addition, try to eat the heavier meals at noon and lighter ones in the evening. The purpose of these suggestions is to have the stomach relatively empty when one lies down so that there is not a lot of “back pressure” to push the stomach contents up the esophagus and into the throat. 

3. Use 4-6 inch bed blocks under the head posts of the bed. Old books or wooden blocks work well for this purpose. This procedure puts the entire bed on a slight downwards slant from head to foot. You may need a pillow under your knees to keep yourself from sliding down. Gravity assists in keeping the stomach acid where it belongs. 

4. You may be prescribed an acid-reducing medicine such as Prilosec OTC, Prevacid, Nexium, Aciphex, or Protonix. Take these medications one hour before breakfast. Treatment of this problem will usually require a 3 month treatment before the medication can be decreased or discontinued. Make sure to refill your medications and continue the treatment. Use a bedtime dose of a simple antacid such as Gaviscon or Maalox in order to reduce acidity. 

5. Weight loss: It is recommended that a trial of the above measures be continued for a minimum 3-4 weeks and that none of the above treatments are omitted. 

If you have further questions, please do not hesitate to call our office at (407) 846-4000

Our Mission is to Educate, Prevent, Test and Treat Allergic, Respiratory and Immunologic Diseases

Dr. Ahmed & staff welcome you to the Asthma, Allergy & Immunology Wellness Institute!  Good health is our concern and we help you breathe better.  As you know, nothing matters if you cannot breathe.  To serve our patients in Central Florida, including Orlando, Kissimmee, St. Cloud etc., we have locations in Kissimmee, St. Cloud and Poinciana, Florida.


At Asthma, Allergy & Immunology Wellness Institute, we offer diagnosis and treatment of:

  • Allergies
  • Recurrent Infections (ear, throat, sinus, skin)
  • Allergic skin diseases or reactions
  • Hives
  • Eczema
  • Immune disorders (More Information)


Click here to make an appointment with Dr.Ahmed

What is an Allergy Skin Test?

It is a test where small drops of certain allergens like pollens, cat dander, dust mites, food extract, insect venom, and medication extract are placed on your skin by making a small indentation or “prick.” That area will have a small reaction if you are allergic to that specific allergen. A positive skin test will identify those allergens which are likely to produce your allergic symptoms. The skin reactions will develop locally in the skin within 15 minutes. Positive skin test reactions will look like a mosquito bite; they will develop an area of redness around them and welt. These positive tests will also itch. The itching will last for only about 15 to 30 minutes; the welt will disappear over the next few hours.


1.      Take all of your medications except Anti-histamines, Allegra, Benadryl, Zyrtec, Claritin, Cetirizine, Loratadine, Xyzal, Clarinex, Alavert or any cough syrup.

2.      Do not take ANY allergy, sinus or cold medications 8 days prior to testing.

3.      On the day of the test, it is very important to have breakfast and/or lunch before you come for your skin test.

4.      Take antibiotics and nose sprays except Astelin, Patanase, and Astepro as prescribed.

5.      You can take Tylenol or any other pain medications

6.      If you are on Beta-Blockers, Heart Medications and/or Anti-Depressant medications, let the doctor know.

7.      If you have a fever, cough, cold, wheezing, chest pain, the flu, sun burned skin on the back, or skin peeling on the back from sun burn, NO skin testing can be done

8.      Please dress in loose fitting clothing, as skin testing is done on the back and/or arms.

9.      The skin test will take approximately 2 hours, so please plan your schedule accordingly, please do not be late. If you are late it may be necessary to reschedule your appointment. Please make sure that you have a referral or authorization for the test, from the primary doctor if needed by your insurance.

10.  Please bring all medications with you

11.  Do not hesitate to ask any questions you have.


Please call us at (407)-846-4000 if you have any questions

Our Mission is to Educate, Prevent, Test and Treat Allergic, Respiratory and Immunologic Diseases

Skin allergy testing is a method for medical diagnosis of allergies that attempts to provoke a small, controlled, allergic response.

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