I have frequent sore throat with bad acid reflux problem. Should I concern about malignancy?

Hi,

Welcome to icliniq.com.

I had a detailed look at the picture you have sent (attachment removed to protect patient identity).

The most common reason for having this irritation in the throat with generalized soreness or to one side can definitely be a feature of chronic silent GERD with LPR (gastroesophageal reflux with laryngopharyngeal reflux).

Even though you might be asymptomatic in between, the inflammation in the throat often exists in the hidden form and can resurface when adequate care is not taken.

Why does hidden acid reflux become so problematic? As you know the stomach usually has got cells that release hydrochloric acid and thus keep the gastric environment acidic in nature. Your entire mucosal lining from the mouth, throat, and food pipe (esophagus) is not meant to handle anything acidic. Of the three structures, the throat is the most sensitive due to its rich nerve supply. If in a given situation, your mouth, throat or food pipe chronically comes in contact with acidic contents, an inflammation starts which the body initially takes care of, but once this compensation wears out, you start developing symptoms that you have mentioned.

Please try to follow the advice mentioned below:

1. Maintain a strict diet, eating on time.

2. Avoid spicy oily, cold food, and drinks.

3. Keep a gap of two hours between meals and going to bed.

4. Do not overeat, rather keep your stomach half empty and have regular intermittent light food like fresh cut fruits in between major meals.

5. Saltwater gargling 8 to 10 times a day for 15 days.

6. Avoid alcohol and smoking as it can potentiate reflux.

7. Fluticasone propionate has no role here and gives a false feeling of relief which is short lived and the problems usually return back to the same state.

8. Keep sipping on boiled warm water every two hours for the next one month.

Treatment plan:

Tablet Pan D 40 mg (Pantoprazole) once in the morning before breakfast for one month, syrup Mucaine gel (or its equivalent) one tablespoon three times a day 20 minutes before meals for one month. The intention of giving this for one month is to treat the problem completely to prevent the possibility of the relapse.

Make sure you follow the precautionary measures as much as possible as mere medications will not fetch long term relief. This typically takes around two to three weeks for things to normalize and for symptoms to subside.

There is absolutely nothing that you need to worry about as this is a treatable entity and things will be fine in a few weeks duration. I do not see the possibility of a throat malignancy over here as the features involving a malignancy are different. There is nothing that you need to worry as far as malignancy is concerned.

I hope this helps.

Hi,

Welcome back to icliniq.com.

Yes, you can take Esomeprazole, but I am of the opinion that 40 mg twice a day 30 minutes before food would be better and faster acting rather than 20 mg. You can use syrup Gaviscon one teaspoon three times (after breakfast, lunch, and dinner) 10 minutes after meals in addition to the above medications.

If the reflux gets too severe in spite of the medications mentioned above, you can take one tablet of Tums plus 1 hour after meals. Tums contains Calcium carbonate and does give symptomatic relief as far as reflux symptoms are concerned. As I said, this might take a while for the symptoms to come down but it chiefly depends on the extent of the precautionary measures being followed.

I hope this helps.