Acid Reflux in the Throat
The Allergy Clinic
Specialists in Allergy & Asthma Care
Specialists in Allergy & Asthma Care
A patient goes to the doctor. The doctor says, “you’re fat”. The patient says, “I want a second opinion”.
The doctor says, “OK, you’re ugly, too.” The old joke has a point. Just because you have one ailment
does not mean you can’t have another going on at the same time.
We often see patients with complaints of sore throat, the frequent need to clear their throat, and chronic
cough. Many have allergies. The allergic rhinitis (literally, inflammation of the nose) causes excess
mucus to be produced in the nose. Gravity drains the mucus down the throat, where it irritates cough
receptors, and the coughing starts. Constantly clearing your throat is not only bothersome, it also
worsens your sore throat. Delicate muscles designed to swallow are not built to clear mucus all day long,
so you can literally “pull a muscle” in your throat.
Treatment of the allergy usually helps, but doesn’t always improve things 100%. Why not? Many
people also have some reflux of stomach acid going on. Maybe it’s just a teeny, tiny bit of acid,
not even enough to cause symptoms of heartburn. Even so, if the acid reaches up to the throat, the
exact same symptoms can occur: sore throat, too much mucus in the throat, a continual need to clear
the throat, and cough, cough, cough.
Believe it or not, treating Laryngo-Pharygeal Reflux (LPR) is more difficult than treating
Gastroesophageal Reflux Disease (GERD). Those acid blocking medicines, like Nexium, Prevacid and
Aciphex, do a great job at relieving GERD when taken once a day, with or without meals. Frequently,
though, they need to be taken twice a day to work for LPR, and often only work if taken 60 minutes
before meals. Why is that? I guess that a moderate degree of acid reduction makes your esophagus
feel better; it lives next door to the stomach and is built for heavy duty use. But your throat is very
delicate, and can tolerate only a very small amount of acid before crying out for help. Also, Nexium
makes your heartburn feel better within a few days, but twice daily Nexium can take months of regular
use before LPR symptoms of constant throat clearing, cough, and sore throat improve. In addition to
twice daily use of Nexium or Aciphex, many LPR patients also require bedtime use of Zantac 300 mg
(that's 4 of the 75 mg) or Pepcid 40 mg (that 4 Pepcid AC's)
Here are some tips from the American Academy of Otolaryngology's Public Web site on reducing reflux:
Adult Lifestyle Changes To Prevent GERD And LPR
Avoid eating and drinking within two to three hours prior to bedtime
Do not drink alcohol
Eat small meals and slowly
Limit problem foods:
Caffeine
Carbonated drinks
Chocolate
Peppermint
Tomato and citrus foods
Fatty and fried foods
Lose weight
Quit smoking
Wear loose clothing
***Table Courtesy of American Academy of Otolaryngology--Head & Neck Surgery****
The doctor says, “OK, you’re ugly, too.” The old joke has a point. Just because you have one ailment
does not mean you can’t have another going on at the same time.
We often see patients with complaints of sore throat, the frequent need to clear their throat, and chronic
cough. Many have allergies. The allergic rhinitis (literally, inflammation of the nose) causes excess
mucus to be produced in the nose. Gravity drains the mucus down the throat, where it irritates cough
receptors, and the coughing starts. Constantly clearing your throat is not only bothersome, it also
worsens your sore throat. Delicate muscles designed to swallow are not built to clear mucus all day long,
so you can literally “pull a muscle” in your throat.
Treatment of the allergy usually helps, but doesn’t always improve things 100%. Why not? Many
people also have some reflux of stomach acid going on. Maybe it’s just a teeny, tiny bit of acid,
not even enough to cause symptoms of heartburn. Even so, if the acid reaches up to the throat, the
exact same symptoms can occur: sore throat, too much mucus in the throat, a continual need to clear
the throat, and cough, cough, cough.
Believe it or not, treating Laryngo-Pharygeal Reflux (LPR) is more difficult than treating
Gastroesophageal Reflux Disease (GERD). Those acid blocking medicines, like Nexium, Prevacid and
Aciphex, do a great job at relieving GERD when taken once a day, with or without meals. Frequently,
though, they need to be taken twice a day to work for LPR, and often only work if taken 60 minutes
before meals. Why is that? I guess that a moderate degree of acid reduction makes your esophagus
feel better; it lives next door to the stomach and is built for heavy duty use. But your throat is very
delicate, and can tolerate only a very small amount of acid before crying out for help. Also, Nexium
makes your heartburn feel better within a few days, but twice daily Nexium can take months of regular
use before LPR symptoms of constant throat clearing, cough, and sore throat improve. In addition to
twice daily use of Nexium or Aciphex, many LPR patients also require bedtime use of Zantac 300 mg
(that's 4 of the 75 mg) or Pepcid 40 mg (that 4 Pepcid AC's)
Here are some tips from the American Academy of Otolaryngology's Public Web site on reducing reflux:
Adult Lifestyle Changes To Prevent GERD And LPR
Avoid eating and drinking within two to three hours prior to bedtime
Do not drink alcohol
Eat small meals and slowly
Limit problem foods:
Caffeine
Carbonated drinks
Chocolate
Peppermint
Tomato and citrus foods
Fatty and fried foods
Lose weight
Quit smoking
Wear loose clothing
***Table Courtesy of American Academy of Otolaryngology--Head & Neck Surgery****