Acid Reflux

How Does Stomach Acid Affect My Throat?

Reflux of stomach juice, particularly acid, can cause a variety of problems in the esophagus (swallowing tube) as well as in the throat. Hoarseness (chronic or intermittent), swallowing problems, a lump in the throat sensation, or throat pain are common symptoms of stomach acid irritation of the throat. Heartburn is an esophageal problem that arises from acid irritation of that structure.  When gastroesophageal reflux disease (GERD), rises higher and reaches the throat, it may be alternatively called supraesophageal reflux or laryngopharyngeal reflux (LPR).  Not all people experience heartburn; the esophagus is actually more resistant to stomach acid than the tissues of the throat.  LPR symptoms include sore throat, globus sensation or lump in the throat, throat clearing, excess mucous in the throat, cough, and hoarseness.

Gastroesophageal reflux disease, or GERD, occurs when acid from the stomach moves backwards into or through the esophagus. Normally, a ring of muscle at the bottom of the esophagus functions to prevent the acidic contents of the stomach from “refluxing”. For a variety of reasons, this does not always function as it should.  This can include excessive weight pushing on the stomach, pregnancy, or a hernia of the stomach.  GERD can happen to anyone, at any age, including infants.

Individuals with acid reflux should try to lose weight, avoid alcohol, eat smaller more frequent meals, stop eating at least two hours before bedtime, and sleep with their bed inclined so the body is not in a fully reclined position (a brick under the legs of the top of bed or a wedge under the mattress is preferable to multiple pillows which can actually make it easier for the stomach to reflux).  Caffeine, carbonated drinks, chocolate, peppermint, tomato and citrus foods, fatty and fried foods, as well as smoking are all associated with increased acid production and should be limited.

Most of the time symtoms of GERD and LPR are treated based on clinical suspicion with alterations in lifestyle and trials of various medications.  When the symptoms do not resolve or come back after discontinuation of treatment, additional testing may be recommended.  Much less frequently, severe cases may require additional intervention.

GERD left untreated can lead to chronic inflammation and changes in the structure of effected tissues.  Conditions, including Barrett’s esophagus, may develop that can eventually evolve into cancer.