Persistent Throat Phlegm: When to Seek Advanced Gastroenterology Care

Q: Persistent Throat Phlegm: When to Seek Advanced Gastroenterology Care

Hello： In addition to medication, it is important to make adjustments in diet, lifestyle, and emotional well-being. <br>If there is no improvement, it is advisable to return to the original clinic for adjustments, as changing locations may not necessarily be the best option. <br>

Having a sensation of a lump in the throat with phlegm?

Hello, doctor...
I had an upper gastrointestinal endoscopy on November 15, which showed mild gastritis and erosion, and I was diagnosed with Grade A gastroesophageal reflux disease.
The doctor prescribed medication for my stomach, advising me to take it for at least a month.
I have been taking it for about 20 days now, but my throat feels tight and uncomfortable with phlegm.
I sleep well at night, but I start burping as soon as I wake up in the morning.
My throat often feels congested with phlegm, and I frequently need to clear my throat.
Sometimes, when I cough forcefully, a small amount of clear phlegm comes up.
I have been careful with my diet and have completely avoided irritating foods.
The doctor at the clinic mentioned that there are better imported medications available at a larger hospital, but he said my symptoms do not require such medications.
After nearly three weeks of treatment, my symptoms have not improved.
Doctor, will my symptoms improve if I continue taking the medication? Should I consider switching to a medical center for further evaluation?

Niming, 30~39 year old female. Ask Date: 2018/12/03

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: In addition to medication, it is important to make adjustments in diet, lifestyle, and emotional well-being.
If there is no improvement, it is advisable to return to the original clinic for adjustments, as changing locations may not necessarily be the best option.
It is recommended to avoid tea, coffee, tobacco, and alcohol, and to avoid overeating.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2018/12/03

More Info

Persistent throat phlegm can be quite uncomfortable and may indicate underlying issues related to gastroesophageal reflux disease (GERD) or other gastrointestinal conditions. Given your history of mild gastric inflammation and GERD, it’s understandable that you are concerned about the persistent phlegm and throat discomfort you are experiencing.

First, it’s important to recognize that GERD can lead to symptoms beyond just heartburn or acid reflux. The reflux of stomach contents can irritate the throat and cause symptoms such as phlegm, throat clearing, and even chronic cough. The fact that you experience these symptoms primarily in the morning may suggest that acid reflux is occurring during the night, leading to irritation upon waking.

You mentioned that you have been on medication for about 20 days, and while you have made dietary adjustments to avoid irritants, it’s crucial to understand that medications like proton pump inhibitors (PPIs), which are commonly prescribed for GERD, may take some time to fully alleviate symptoms. However, if you find that your symptoms have not improved after this period, it may be time to reassess your treatment plan.

Here are some considerations regarding your situation:
1. Medication Efficacy: If you are taking a PPI and still experiencing significant symptoms, it may be worth discussing with your doctor whether the dosage is adequate or if a different medication might be more effective. Sometimes, a higher dose or a different class of medication may be necessary to control symptoms effectively.

2. Lifestyle Modifications: In addition to medication, lifestyle changes can significantly impact GERD symptoms. Elevating the head of your bed, avoiding large meals before bedtime, and maintaining a healthy weight can help reduce nighttime reflux. Additionally, keeping a food diary to identify any potential triggers can be beneficial.

3. Further Evaluation: If your symptoms persist despite medication and lifestyle changes, it may be appropriate to seek further evaluation from a gastroenterologist, particularly one at a specialized center. They can perform additional tests, such as pH monitoring or esophageal motility studies, to assess the severity of your reflux and determine if there are any other underlying issues that need to be addressed.

4. Alternative Treatments: In some cases, gastroenterologists may recommend additional treatments, such as surgical options for GERD, if conservative measures fail. This is typically considered when symptoms are severe and significantly impact quality of life.

5. Throat Symptoms: Persistent throat phlegm can also be related to other conditions, such as allergies or post-nasal drip. If your gastroenterologist rules out GERD as the primary cause, they may refer you to an ear, nose, and throat (ENT) specialist for further evaluation.

In conclusion, while it is common for GERD symptoms to take time to improve with medication, the persistence of your throat phlegm and discomfort warrants a follow-up with your healthcare provider. If you feel that your current treatment is not effective, don’t hesitate to seek a second opinion or ask for a referral to a gastroenterology specialist. Your comfort and health are paramount, and there are various avenues to explore for relief.

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