Throat Reflux: Symptoms, Treatment, and Concerns - Otolaryngology

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Understanding throat reflux, also known as laryngopharyngeal reflux (LPR), is crucial for managing symptoms and improving quality of life. Your experience with persistent throat discomfort and the sensation of a foreign body is common among individuals suffering from this condition. It often arises when stomach acid flows back into the throat, leading to inflammation and irritation.


Symptoms and Diagnosis
The symptoms you describe, including the sensation of a lump in the throat (often referred to as "globus sensation"), the presence of phlegm upon waking, and the discomfort that persists throughout the day, are indicative of LPR. The white phlegm you are experiencing may suggest that there is indeed some inflammation in your throat, which could be a result of the acid reflux irritating the mucosal lining.

Treatment and Medication
You mentioned that you have been prescribed a medication called "怡胃適腸溶錠," which is likely a proton pump inhibitor (PPI) or an antacid designed to reduce stomach acid production. These medications typically require a course of several months to effectively manage symptoms and heal any damage caused by acid reflux. It is not uncommon for symptoms to fluctuate during treatment, and a resurgence of symptoms after initial improvement can be frustrating.

1. Inflammation and Phlegm: The presence of white phlegm and the sensation of swelling in your throat could indeed indicate inflammation. This inflammation can be exacerbated by acid reflux, leading to increased mucus production as a protective response.
2. Further Investigation: If your symptoms have returned after two and a half months of treatment, it may be beneficial to consult your physician about the possibility of an endoscopy (gastroscopy). This procedure allows for a direct examination of the esophagus and stomach, helping to identify any underlying issues that may not be addressed by medication alone.

3. Medication Duration and Side Effects: Long-term use of PPIs can lead to side effects, including nutrient malabsorption (such as magnesium and vitamin B12), increased risk of gastrointestinal infections, and potential kidney issues. It is essential to discuss your concerns with your healthcare provider, who can evaluate the necessity of continuing the medication and consider alternative treatments if needed.

4. Concurrent Treatment for Throat Inflammation: It is reasonable to consider adjunctive treatments for throat inflammation while continuing your acid-reducing medication. Over-the-counter remedies such as throat lozenges, saline gargles, or even anti-inflammatory medications (like ibuprofen) can provide symptomatic relief. However, it is crucial to consult your doctor before starting any new medications to avoid potential interactions.


Lifestyle Modifications
In addition to medication, lifestyle changes can significantly impact the management of LPR. Here are some recommendations:
- Dietary Adjustments: Avoid trigger foods that can exacerbate reflux, such as spicy foods, caffeine, chocolate, and acidic foods. Eating smaller, more frequent meals can also help.

- Posture and Timing: Avoid lying down immediately after eating and try to elevate the head of your bed to reduce nighttime reflux.

- Hydration: Staying well-hydrated can help thin mucus and reduce throat irritation.


Conclusion
In summary, your symptoms of throat discomfort and phlegm production are likely related to laryngopharyngeal reflux. While your current medication has provided some relief, the recurrence of symptoms warrants further evaluation. A combination of continued acid suppression, possible adjunctive treatments for throat inflammation, and lifestyle modifications can help manage your condition effectively. Always consult your healthcare provider before making any changes to your treatment plan to ensure a safe and coordinated approach to your health.