When stomach acid travels up in your throat

Have you ever experienced hoarseness of the voice due to chronic cough? Or that urge to clear your throat frequently? Was this associated with or without a heart burn?

If you went through all that, then, you are likely to be having a condition medically known as Laryngopharyngeal Reflux Disease (LPR).

It happens when acid from the stomach travels up in your throat.

Usually, the acid is made from the stomach in response to various stimuli, including food intake. The function of this acid is to activate initial enzymes for protein breakdown as well as inhibiting the growth of some harmful bacteria in your food canal.

This acid is prevented from flowing back by a muscular valve called oesophagus sphincter (food pipe). However, when this muscle is not functioning, the acid may flow back (reflux) to the oesophagus, throat (pharynx) and voice box (larynx).

The oesophagus has its protective mechanism in which it may not be irritated by a small amount of acid flowing back but the throat and voice box are very sensitive.

Symptoms

Some of the more common symptoms seen in the patients with this condition are; sensation of drainage down the back of the throat or excessive mucus, feeling of something caught in the throat (sometimes a tickling or burning sensation), throat clearing, chronic cough, post-nasal drip, sore throat, hoarseness, difficulty swallowing, prolonged vocal warm-up (for singers) and loss of the high end of the vocal rang.

When a doctor is diagnosing this condition, he bases on the clinical symptoms, medical tests that will include the amount of acid reflux measured in 24 hours.

The doctor will also examine both your voice box and throat for any sign of inflammation (swelling) or irritation. Due to its non-specific symptoms, it is often underdiagnosed or misdiagnosed.

Treatment using drugs involves suppression of acid production by use of the drugs called proton pump inhibitors.

However, it is recommended that the general approach to treatment of this condition is by the patients changing their diet.

Dietary changes involve avoiding caffeinated drinks as they have an effect on the valve between the food pipe and the stomach, causing it to weaken.

This can allow the flow back of acidic contents to the food pipe (oesophagus), voice box and throat. Carbonated drinks may have the same effect.

Behavioural changes involve avoiding vigorous exercises for at least two hours after eating. Avoiding eating or drinking for three hours prior to going to sleep.

Dr Mkindi is medical officer based in Dar es Salaam.