Reflux and throat symptoms

At the lower end of the oesophagus (gullet) there is a one-way valve (lower oesophageal sphincter) .

This allows food and fluids to pass into the stomach.

The sphincter should prevent anything from flowing back from the stomach into the oesophagus.

In some people this one-way valve is faulty.

Therefore, irritating stomach acid may flow up from the stomach and into the oesophagus (gullet) and throat.

This may cause indigestion and heartburn (a burning sensation behind the breastbone).

Occasionally people experience only the throat symptoms.
They do not experience indigestion or heartburn.
This is sometimes referred to as “silent” reflux, or laryngopharyngeal reflux).

The reflux may cause throat symptoms such as irritation and burning in the throat, muscle spasm in the throat, and a feeling of a lump in the throat.

Other symptoms include coughing, hoarseness, excess mucus in the throat, and a bad taste in the throat.

The excess mucus in the throat may sometimes be mistaken for a postnasal drip.

 Don’t smoke
 Eat small meals regularly
 Do not rush meals
 Avoid those foods associated with your symptoms, e.g. acidic fruit drinks, spicy meals, alcohol, coffee
 Don’t take aspirin for headaches, colds and coughs- use Paracetamol instead
 Avoid taking anti-inflammatory medications
 Avoid becoming overweight- – if you are overweight, reducing your weight may be of great benefit
 Posture- avoid bending from the waist or stooping just after meals. Try and bend from the knees. Take meals on an upright chair, rather than stooping in front of the TV
 Avoid tight belts and underclothes as they increase pressure on the stomach
 Eat your evening meal well before going to bed so that it has time to digest
 Raise the head of the bed on blocks by 6 inches


 Antacids are available from the chemist – they neutralise any acid in the gullet. Some preparations relieve symptoms by forming a layer on top of the stomach contents, e.g. Gaviscon.
 Other drugs (proton pulp inhibitors or PPIs) actually reduce the production of acid in the stomach (e.g. Losec, Nexiam).
 Medication that enhances the normal movement of the gullet may be of help, eg Motilium

 You suffer from heartburn regularly- every day or every week
 Your heartburn or other symptoms persist for more than 2 weeks
 Your symptoms do not respond to antacids

 Over 45 years old
 Have a family history of stomach problems
 Drink or smoke heavily
 Take aspirin or anti-arthritis pain killers

If you have symptoms suggestive of silent reflux, please call 031 201 3118 for an appointment.
A complete history will be taken, and a thorough examination conducted. This will include a flexible laryngopharyngoscopy.

Further management will depend on the clinical findings, but will be in keeping with best ENT specialist practice guidelines.

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