Introduction

Many common throat problems are caused by irritation of the voicebox (larynx) or other parts of the throat from stomach acid. This condition is known as reflux laryngitis.

What is reflux?

When food is swallowed it enters the stomach where strong acid is produced. The acid helps to digest and break down food. A valve separates the stomach from the throat. This protects the throat from stomach acid. Reflux happens when stomach acid leaks into the throat.A weak valve, too much acid in the stomach or food staying in the stomach too long can cause reflux.

What are symptoms of reflux?

Many people are familiar with the common symptoms of heartburn.This occurs when acid from the stomach irritates the esophagus (the tube from the throat to the stomach).  However, there are many other symptoms that people do not realize can be caused by reflux:

* Hoarseness especially in the morning.

* A lump sensation in the throat.

* Feeling the need to clear one’s throat.

* Mucous sensation in the throat.

* Chronic sore throat.

* Shortness of breath with a feeling that the throat is closing off.

* Foul-tasting acid in the back of the throat

* Difficulty or pain with swallowing.

* Asthma.

* Chronic cough, especially at night.

* Recurrent bronchitis or pneumonia.

* Awakening at night with shortness of breath.

Other symptoms include dry throat, bad breath, white coating on tongue, and earache. And it is important to remember that reflux affecting the throat most often occurs without any symptoms of heartburn.

What to expect at the doctor’s office

The doctor takes a detailed history and performs a physical exam. You may have an exam where a tube is inserted through the nose to see your throat and voice box to make sure a serious condition such as cancer isn’t the cause. Treatment for 6-12 weeks, including medication and/or changes in diet and lifestyle is usually recommended. If initial therapy fails or reflux returns after it stopped, other tests may be recommended.

Treatment

Behavioral Modification

Simple lifestyle changes are often useful in reducing reflux symptoms. Sometimes that alone will reduce the symptoms.Examples of changes include:

* No eating within three hours of bedtime.

* Avoiding spicy, acidic, or fatty foods.

* Cutting back on smoking and alcohol.

* Elevating the head of the bed with blocks or a long foam wedge (just using extra pillows can make the situation worse).

* Wearing loosely-fit clothes around the waist.

Medication

There are over-the-counter and prescription medications that can be very successful in treating reflux laryngitis. Some work by directly neutralizing the acid. Examples of these include Maalox, Mylanta, and Rolaids. Others decrease the amount of acid produced. These include Zantac, Prilosec, and Aciphex. If necessary, your doctor may place you on one of these medicines. These medications can take 8-12 weeks before they start to reduce the throat symptoms

What next?

If medicine and lifestyle changes are unsuccessful there are operations available that decrease the amount of reflux. Few people need to go this far. However, if reflux is left untreated or is poorly treated, it can lead to more serious problems such as throat cancer, scarring of the throat, and damage within the lungs.