Sore throat and acid reflux
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Sore Throat and Acid Reflux: Understanding the Connection
Introduction to Sore Throat and Acid Reflux
Sore throat is a common symptom that can be caused by various factors, including infections, allergies, and irritants. However, one often overlooked cause is acid reflux, specifically gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR). These conditions occur when stomach acid flows back into the esophagus and even up to the throat, causing irritation and inflammation.
Laryngopharyngeal Reflux (LPR) and Sore Throat
Symptoms and Diagnosis
LPR is a type of acid reflux where the stomach contents reach the upper airway, leading to symptoms such as hoarseness, chronic cough, throat clearing, and sore throat4 5 7. Unlike GERD, LPR often occurs during the daytime and in an upright position8. Diagnosis typically involves laryngoscopy, which can reveal erythema and edema of the larynx5 7.
Treatment Approaches
The primary treatment for LPR involves proton pump inhibitors (PPIs), which reduce stomach acid production. Studies have shown that PPIs can significantly improve symptoms such as postnasal drip and sore throat in patients with LPR7 10. However, not all patients respond to PPI therapy, and additional diagnostic tests like pH monitoring may be necessary to tailor treatment1 3.
Gastroesophageal Reflux Disease (GERD) and Sore Throat
Symptoms and Diagnosis
GERD is characterized by the backflow of stomach acid into the esophagus, causing symptoms like heartburn and regurgitation. However, GERD can also present with atypical symptoms, including sore throat, chronic cough, and a sensation of a lump in the throat (globus sensation)4 5. These symptoms can be misleading and require a high index of suspicion for accurate diagnosis.
Treatment Approaches
Treatment for GERD typically involves lifestyle modifications, such as dietary changes and weight management, along with medications like PPIs and H2 receptor blockers5 6. In some cases, surgical interventions like fundoplication may be considered, especially for patients who do not respond to medical therapy1 10.
Role of Gastric Inlet Patches
Ablation Therapy
Gastric inlet patches, areas of heterotopic gastric mucosa in the cervical esophagus, have been associated with chronic sore throat and globus sensation. A pilot study demonstrated that ablation of these patches using argon plasma coagulation (APC) significantly reduced symptoms of sore throat and globus sensation, although it did not affect other reflux-related symptoms2.
Conclusion
Sore throat can be a manifestation of both GERD and LPR, conditions where stomach acid irritates the throat and larynx. Accurate diagnosis often requires a combination of symptom assessment, laryngoscopy, and pH monitoring. Treatment primarily involves acid suppression with PPIs, lifestyle modifications, and in some cases, surgical interventions. Understanding the connection between sore throat and acid reflux is crucial for effective management and improving patient outcomes.
Sources and full results
Most relevant research papers on this topic
Sore throat and a red hypopharynx: is it reflux?
Laryngoscopic evaluation is not sensitive enough for GERD diagnosis, and the patient may benefit from ndoscopy, pH, or impedance monitoring.
Case ReportArgon plasma ablation of gastric inlet patches in the cervical esophagus may alleviate globus sensation: a pilot trial.
Ablation of gastric inlet patches with argon plasma coagulation can alleviate chronic globus sensation or sore throat, without affecting acid reflux or its treatment.
Non-RCTAcid reflux management: ENT perspective.
Voice change, sore throat, globus, and cough choking are the most reliable symptoms of laryngopharyngeal reflux, and flexible oesophago-gastroscopy is a reliable diagnostic tool.
Observational StudyOtolaryngologic manifestations of gastroesophageal reflux.
Gastroesophageal reflux (GER) can cause various head and neck symptoms, and its diagnosis and treatment are crucial for otolaryngologists.
Highly CitedHead and neck manifestations of gastroesophageal reflux disease.
GERD can cause diverse head and neck symptoms without heartburn, and treatment with a histamine H2 receptor blocker or proton pump inhibitor is crucial to prevent chronic laryngitis, dysphonia, chronic sore throat, constant throat clearing, and granuloma of the true vocal cords
Effects of a Proton-Pump Inhibitor on Postnasal Drip Symptoms in Patients With Laryngopharyngeal Reflux
Proton-pump inhibitor treatment for 8 weeks may effectively improve postnasal drip symptoms in patients with laryngopharyngeal reflux.
RCTLaryngopharyngeal reflux and Helicobacter pylori.
Laryngopharyngeal reflux (LPR) is associated with Helicobacter pylori, causing symptoms such as hoarseness, sore throat, and coughing, and can be effectively treated with proton pump inhibitors.
Literature Review
Rigorous JournalAre persistent throat symptoms atypical features of gastric reflux and should they be treated with proton pump inhibitors?
Persistent throat symptoms may not be atypical features of gastric reflux and may not benefit from proton pump inhibitor treatment.
Systematic Review
Very Rigorous Journal