Do you feel something in your throat? It could be reflux.

Sometimes, we feel like there is something stuck in our throats, and we can’t swallow it or cough it out. Some people mistake this annoying foreign body sensation for a cold, chronic pharyngitis, or even worry that it’s a sign of a tumor. But if this feeling recurs, especially after eating, at night, or in the early morning, the possible culprit is actually pharyngeal reflux .

Laryngopharyngeal reflux is not unfamiliar, and many people may have even experienced it, but they just don't realize it exists. It is similar to gastroesophageal reflux, in that the gastric acid and digestive juices in the stomach "restless" and flow upward to places where they shouldn't go. The difference is that gastroesophageal reflux mainly affects the esophagus, while laryngopharyngeal reflux goes further "over the line" and irritates the throat, vocal cords, and even the back of the nasal cavity, causing a series of discomforts.

1. Typical symptoms of laryngopharyngeal reflux

The most "cunning" thing about laryngopharyngeal reflux is that it does not cause obvious heartburn and acid reflux like gastroesophageal reflux. Many people do not even have stomach discomfort, but suffer from throat problems for a long time. This is why it is often misdiagnosed as pharyngitis or other throat diseases. In addition to the typical foreign body sensation in the throat, laryngopharyngeal reflux may also manifest as:

Frequent throat clearing : I always feel like there is phlegm in my throat, but I can’t clear it out no matter how hard I try.

Chronic cough : The cough is more obvious, especially when getting up in the morning, after eating, or when talking a lot.

· Hoarseness : The voice may become tired or even hoarse after talking for a long time.

Dry and burning throat : Sometimes the throat feels dry or even has a slight burning sensation.

Swallowing discomfort : You always feel that your throat is not smooth, or even has a slight pain.

Worsened at night : Symptoms are more likely to occur when lying flat, and the patient may even be woken up by choking or feel suffocated.

Some patients may also experience rhinitis-like symptoms, such as postnasal drip (the feeling of mucus flowing down the throat) or stuffy ears. This is because the reflux irritants may affect the nasopharynx and even the Eustachian tube, causing discomfort.

2. Why does laryngopharyngeal reflux occur?

The stomach contents should go down the digestive tract, so how come they "reverse" to the throat? This is usually related to the relaxation and weakening of the lower esophageal sphincter (the "checkpoint" between the stomach and esophagus). In addition, there are some factors that may aggravate reflux:

Improper diet : Fried, spicy, high-fat foods, coffee, alcohol, and carbonated drinks can stimulate excessive secretion of gastric acid and reduce the tension of the esophageal sphincter.

Eating habits : Eating too fast, eating too much, and lying down immediately after a meal will increase stomach pressure and make it easier for stomach contents to reflux.

Weight problem : Obese people have higher abdominal pressure and are more likely to have reflux.

Nighttime sleeping habits : When lying flat, gravity cannot help stomach acid flow downward, but makes it easier for it to flow upward.

Mental stress : Long-term anxiety and tension may affect gastrointestinal function and increase the risk of reflux.

Drug effects : Certain drugs, such as some antihypertensive drugs, antidepressants, and bronchodilators, may affect sphincter function and increase the possibility of reflux.

3. How to improve laryngopharyngeal reflux?

Although laryngopharyngeal reflux is not a serious disease, long-term and repeated stimulation may affect the quality of life and even lead to chronic pharyngitis and vocal cord damage. In severe cases, it may also increase the risk of esophageal cancer. Therefore, adjusting lifestyle habits is an important way to control laryngopharyngeal reflux.

Diet adjustment is the key. Reduce the intake of foods that stimulate gastric acid secretion, such as fried, spicy, acidic foods, coffee and alcohol, avoid high-fat diet, and focus on light, easily digestible foods. Eat dinner as early as possible and avoid eating 2-3 hours before going to bed to prevent reflux of gastric contents at night.

Adjusting your sleeping position is also important. You can try raising the head of your bed by 10-15 cm to make it harder for stomach acid to flow back up. Sleeping on your side (especially your left side) can also help reduce reflux symptoms.

Control your weight . For overweight or obese people, losing weight can significantly improve reflux symptoms because excess abdominal fat increases stomach pressure and promotes reflux.

Avoid lying down immediately after a meal , especially within an hour after a meal. It is best to stand or sit upright to give the stomach some time to digest and reduce the possibility of reflux.

Reduce throat clearing and overuse , as frequent throat clearing can further irritate the throat and increase inflammation. Rinsing your mouth with warm water or taking sips of warm water can help soothe a sore throat.

Relieve stress . Long-term anxiety and mental tension can affect gastrointestinal function and worsen reflux. Appropriate exercise, meditation, deep breathing training, etc. can help relieve stress and reduce reflux symptoms.

If the symptoms are severe, or they still recur after lifestyle adjustments, you can use some drugs to relieve gastric acid secretion under the doctor's advice, such as proton pump inhibitors or H2 receptor antagonists . However, these drugs should be used under the guidance of a doctor and should not be relied on for a long time.

Conclusion

The foreign body sensation in the throat is not necessarily pharyngitis or a tumor. Laryngopharyngeal reflux is likely the "black hand" behind the scenes. Many people endure discomfort for a long time because they don't understand it, or even use the wrong method, which leads to delayed relief of symptoms. In fact, developing good eating and living habits and avoiding inducements are the most effective ways to improve laryngopharyngeal reflux. If you often feel a blockage in your throat, you might as well pay attention to your diet and daily routine. Maybe adjusting your lifestyle can make your throat feel a lot easier!

Author: Otolaryngology Department of Zhongshan Hospital, First Affiliated Hospital of Guangzhou University of Chinese Medicine