How This Helps

Acid reflux occurs when stomach acids travel back up into the food pipe, or esophagus, and causes irritation to its lining. This irritation can lead to a sore throat, and a persistent, dry cough. It can also cause heartburn, regurgitation, bad taste in the mouth, indigestion, and difficulty swallowing. Diet, natural remedies, and lifestyle changes can help.

Acid reflux and burning throat

Infection usually causes a sore and burning throat in the throat and airways. A long-term sore throat that doesn't respond to standard treatment may be due to acid reflux. But how can acid reflux damages the mucous membranes? 

See: GERD diet plan to prevent heartburn

What is acid reflux?

What is acid reflux vs. silent reflux?

Reflux refers to the rise of stomach contents into the esophagus. When the acidic gastric juice irritates the esophagus, it causes typical signs like heartburn. Acid reflux is also called gastroesophageal reflux disease (GERD). Reflux can also be gaseous, increasing through the esophagus and reaching the airways. This sort of reflux is called laryngopharyngeal reflux, airway reflux, or also as silent reflux, since it causes unspecific symptoms, like a sore throat or hoarseness. Lots of people with silent reflux do not recognize that their symptoms are due to the condition, and it may take several years to be given the right diagnosis.


See: Mustard for heartburn & acid reflux relief

How does acid reflux causes a sore throat?

A sore throat due to acid reflux may be caused by a condition called laryngopharyngeal reflux (LPR) or silent reflux. This occurs when stomach contents, including acid and enzymes, back up into the esophagus and injure the tissues of the larynx (voice box) and pharynx (throat). The reason is the malfunctioning of the upper and lower esophageal sphincter muscles. These muscles should keep food moving in the right direction, from mouth to stomach. The lower esophageal sphincter prevents stomach acid from moving up the esophagus. When it malfunctions, stomach acid irritates the esophageal tissue immediately above the gut, causing symptoms such as heartburn and chest pain with swallowing. This problem is known as gastroesophageal reflux (GERD).

The upper esophageal sphincter keeps stomach acid from the pharynx and larynx. When it does not work correctly, it is possible to create symptoms such as hoarseness, loss of voice, chronic cough, phlegm in the back of the throat, and a sense that something is stuck in the throat. Even though the stomach contents come in contact with the lower limb before reaching the throat, only about 35 percent of individuals with LPR also experience GERD. Experts do not know why. It might be that the larynx and pharynx are more sensitive to acidity than the esophagus. Additionally, refluxed acid is more likely to pool at the larynx and pharynx, leading to prolonged exposure.  

See: Functional medicine for GERD

Acid reflux symptoms for sore throat

Symptoms of LPR or silent reflux

When stomach acid flows into the throat and larynx, it can result in long-term irritation and damage to the throat tissue. Silent reflux can scar the voice box and throat in adults. It may also increase the risk for cancer in the region, affect the lungs, and might aggravate conditions like asthma, emphysema, or bronchitis. Since silent reflux symptoms affect the larynx in contrast to the esophagus, like GERD, it's harder to diagnose and might go untreated. A physician can diagnose silent reflux by performing medical tests.

Common symptoms of silent reflux include:

- Hoarseness while speaking (frequently caused by silent reflux): The larynx is very near the esophagus and any possible reflux. At precisely the same time, our voice reacts strongly to some disturbance. So even minor inflammation can result in serious voice difficulties. Most problems occur when the vocal cords are inflamed, as those are used to speak. 

- Sore or burning throat: An inflamed and painful throat is frequent for LPR. Silent reflux shoots up your stomach and then into your own throat. So it is no surprise that many suffer from sore throat.

- Asthma-like symptoms: Many experts have started to proclaim that many patients that are Treated for asthma really have reflux. The symptoms are incredibly similar.

- Chronic cough: In the same manner that silent reflux can cause asthma, it may also make you cough. This stems from damages to your lungs. Additionally, LPR strikes the mucous membrane on your airways. This irritation can lead to a cough and throat clearing also.

- Globus syndrome or lump in the throat sensation: Many people feel like they have a lump in their throat, or just like something is stuck there. Inflammation causes swelling of your mucus membranes. When you've got silent reflux, you may really have something such as a lump on your neck, such as a bulge of swollen tissue.

- Dysphagia or swallowing problems: The inflamed throat can cause swallowing problems or Dysphagia.

- Frequent Belching: Many silent refluxers report that they belch a fair amount. However, it's hard to define whether that's a symptom or the cause of LPR. Every time we belch, air comes up and maybe transports pepsins and acids with it. Some belching is ordinary. Just when it becomes too much, it may cause the signs of silent reflux.

- Post-nasal drip: This is the common runny nose, just the mucus runs down your throat.

- Irritated Mucous Membrane: Silent Reflux can irritate your system wherever it goes. So all sections of your throat, nose, and airways can potentially be at risk of being irritated. Some people suffer in their mouths, with a sensation of a burning tongue. Others may suffer from their nose. 

- Excessive mucus in your throat: When our mucous membranes are irritated, they often produce more mucus as a defense mechanism.

- Nausea: Some people get the feeling of needing to vomit from quiet reflux. That's simply because your throat gets aroused and can cause a vomit reflex. 

- Frequent infections: If your mucous membranes are inflamed frequently, it lowers your defenses from beating infections. That's the reason silent reflux patients are more affected hit by germs.


See: Is yogurt good for acid reflux & heartburn

Natural remedies & lifestyle changes

LPR is generally diagnosed by symptoms, though a specialist may look directly in the area with a laryngoscope for signs of swelling and inflammation. The treatment of LPR starts with changes in diet and lifestyle behavior, including these:

- Prevent highly acidic or spicy foods and drinks like citrus fruits and juices, tomatoes, salad dressings, and barbecue or hot peppers. These foods irritate the cells lining the throat and voice box.

- Avoid alcohol, caffeine, chocolate, and peppermint, which weaken both esophageal sphincters. Even decaffeinated teas and teas contain enough caffeine to cause difficulty. Some substances in peppermint and chocolate also stimulate stomach acid production.

- Pick smaller meals spread throughout the day instead of large meals, which exert pressure on the lower esophageal sphincter.

Do not drink carbonated drinks: they can cause belching, which promotes the reflux of stomach contents.

Do not smoke: nicotine stimulates acid production.

- Avoid vigorous exercise, heavy lifting, or bending over immediately after ingestion.

- Do not drink or eat for a couple of hours prior to going to sleep.

If diet and behavior changes do not help, medicine may be prescribed. They all work by lowering the quantity of acid made in the stomach.


See: Ginger for acid reflux relief

Can you tell if sore throat is caused by acid reflux?

How to recognize a sore throat is caused by acid reflux

It's difficult to find features that differentiate a sore throat caused by acid reflux from a sore throat through other causes. One clue may be the duration of the soreness in the throat. When the sore throat lasts for quite a long time and isn't due to cold or other ailments, acid reflux is a probable cause. Acid reflux can cause not just a sore throat but other symptoms as well. By assessing it in conjunction with other symptoms, the probability of acid reflux being the cause can be determined accurately.

Tests to Diagnose for Silent Reflux

- Esophageal pH (acid) Evaluation - quantify the amount of acid in the throat and esophagus over 24 hours

Upper endoscopy- having a flexible tube to view the throat and vocal cords

- Silent reflux can be handled and handled in similar ways used to manage GERD. Specific lifestyle changes can be made to alleviate these symptoms in addition to some medications which can be used to control gastric acid.

If these treatments alone are not effective in relieving silent reflux symptoms, please consult with your physician.


See: Acupuncture And Traditional Chinese Medicine helps with GERD and Digestion Problems

Tips & tricks to get rid of sore throat

Treatment of sore throat due to acid reflux: A sore throat that's caused by acid reflux cannot be treated with normal OTC flu or cold medicine. To get rid of the sore throat and other symptoms, acid reflux should be eliminated at the root cause as much as possible. Dietary changes can make a significant impact on silent reflux. Because acidic foods and beverages can activate pepsin in their way into the gut, preventing them improves symptoms. Medications that reduce acid production in the stomach, known as proton-pump inhibitors (PPIs), are often prescribed for silent reflux. These medications can decrease heartburn, but they do work well for airway symptoms like a sore throat. The reason is that the harm isn't just due to acid alone but in conjunction with the gut enzyme pepsin. Acid suppressing medication doesn't affect pepsin.

See: Ayurvedic herbs for immune system

Risk factors in silent reflux

Stomach acid that pools in the throat and larynx (voice box) can cause long-term irritation and damage, and without treatment, it may lead to serious issues. In adults, silent reflux can scar the throat and voice box and increase the risk of cancer in the region. The lungs may also be affected, and it can aggravate current conditions like bronchitis, asthma, or emphysema. Consult a doctor and seek medical attention.

See: Yoga for GERD

References

1. Kahrilas, P. J. (2018, January 31). Complications of gastroesophageal reflux in adults. https://www.uptodate.com/contents/complications-of-gastroesophageal-reflux-in-adults?search=complications-of-gastroesophageal-reflux-in-adults%EF%BB%BF&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

2. Laryngopharyngeal reflux. (2012, April 16) https://my.clevelandclinic.org/health/diseases/15024-laryngopharyngeal-reflux-lpr

3. Mayo Clinic Staff. (2015, November 18). Infant reflux: Symptoms and causes http://www.mayoclinic.org/diseases-conditions/infant-acid-reflux/symptoms-causes/dxc-20157641

4. Waring, J. P. (2016, February 10). Laryngeal pharyngeal reflux http://www.aboutgerd.org/laryngeal-pharyngeal-reflux.html

5. Worried your sore throat may be strep? (2018, January 31) https://www.cdc.gov/features/strepthroat/index.html

6. Ahuja, V., Yencha, M. W., & Lassen, L. F. (1999, September 1). Head and neck manifestations of gastroesophageal reflux disease. American Family Physician, 60(3), 873-880 http://www.aafp.org/afp/1999/0901/p873.html

7. Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope. 1991;101(S53):1-78.

8. Laryngopharyngeal Reflux (LPR). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15024-laryngopharyngeal-reflux-lpr. 

9. Koufman JA. Low-acid diet for recalcitrant laryngopharyngeal reflux: Therapeutic benefits and their implications. Ann Otol Rhinol Laryngol. 2011;120(5):281-7.

10. Cochran, W. J. (2017, February). Gastroesophageal reflux in infants. Merck Manuals

https://www.msdmanuals.com/en-gb/professional/pediatrics/gastrointestinal-disorders-in-neonates-and-infants/gastroesophageal-reflux-in-infants

11. Diphtheria symptoms. (2016, January 15) https://www.cdc.gov/diphtheria/about/symptoms.html

See: What does heartburn feel like

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