Like other reflux symptoms, these can be worse after eating. If you suffer from acid reflux and frequently wheeze or cough up mucus when eating, it’s important to recognize these symptoms so you can seek medical attention. GERD produces heartburn symptoms because stomach acid flows upward into your esophagus, irritated its lining. LPR causes stomach acid to creep back up, as well, but it doesn’t stay there long enough to produce heartburn. But it comes up in the throat, irritating it and the voice box.
If the acid reflux continues, the damage to the vocal cords will progress. We still agree that this can occur, but the train has accelerated to the fast track.
Treatments for viral infections, allergies, and sinusitis are discussed in other sections. Acid reflux is treated with over-the-counter or prescription medications, depending upon the severity of the symptoms. Other causes are less common and should be thoroughly evaluated by an ENT specialist.
Acid controlling medications don’t treat the cause of acid reflux, they just reduce stomach acid. The only way to stop acid reflux completely is to correct the weakness in the LES with reflux surgery.
The feeling that there is something stuck in the throat, a globus sensation, is a classic symptom of LPR. Many people with throat discomfort are surprised when they are told by their doctor that they have laryngeal pharyngeal reflux (LPR). Gastric acid can cause significant inflammation when it falls on the vocal cords. So, my plea to you is to take a good voice history, listen to the patient, look for habituation, develop a relationship with a speech-therapy rehabilitation clinician or a laryngologist who has a vested interest in voice. These patients will need speech rehabilitation, and the habits will go away with time.
If coughing symptoms improve during this time, it can indicate the cough is related to acid reflux. The amount of stomach acid needed to irritate the lining of the throat and voice box is quite small. Only 50 percent of those with LPR experience heartburn. Of course, in some cases, chronic cough may be caused or made worse by acid reflux.
The studies that have looked at this have used high-dose, twice-daily therapy, and there was no response after 3 months of therapy. Even though they had GERD, it didn’t predict which patients would have beneficial outcomes.
A variety of findings in the larynx can be nonspecific, such as erythema, edema, swelling, and cobblestoning. These findings can be induced by other conditions, such as postnasal drip, allergies, asthma, voice abuse, and even by repetitive behaviors such as throat clearing.