I have throat irritation with blisters, and swallowing difficulty. Kindly help.

Hi,

Welcome to icliniq.com.

The most common reason for having this throat irritation with a feeling of a lump or something obstructing while swallowing saliva can be a feature of chronic silent GERD with LPR (gastroesophageal reflux with laryngopharyngeal reflux). Even though you might be asymptomatic or never had gastric issues in between, the inflammation in the throat often exists in the hidden form and can resurface when adequate care is not taken. I will explain the reason why hidden acid reflux become so problematic. As you know the stomach usually has cells that release hydrochloric acid and thus keep the gastric environment acidic. 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 where 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 and cold food/drinks. 3. Keep a gap of two hours between meals and going to bed. 4. Do not over eat, rather keep your stomach half empty and have regular intermittent light food like fresh cut fruits in between major meals. 5. Salt water gargling 8 to 10 times a day for 15 days. 6. Avoid alcohol and smoking as it can potentiate reflux. 7. Try to maintain a left lateral position while sleeping to reduce the chance of reflux. Treatment plan: Take tablet Pan D (Pantoprazole and Domperidone) 40 mg 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. Make sure you follow the precautionary measures as much as possible as mere medications will not fetch a long term relief. Please understand that this typically takes four to six weeks for things to normalize and for symptoms to subside. And it chiefly depends on how much you have follow the precautions mentioned above, as 80 percent of the treatment lies there. There is absolutely nothing that you need to worry about as this is a treatable entitity and things will be fine.

Hi,

Welcome back to icliniq.com.

There is no requirement for any laryngoscopy for now. Please make sure you follow the advice mentioned below in addition to what I have mentioned in our previous conversation. 1. Avoid anything (even if homemade), which can trigger gastritis. 2. Avoid citrus fruits, fermented food items (eg, butter, curd, cheese). 3. Avoid having any packed juices as they contain preservatives, which can again trigger reflux. There is absolutely nothing that you need to worry about. All that you need to do is avoid unnecessary medications. Keep a strict schedule of the diet, and wait for at least two to three months time. The treatment in this particular entity is not easy, and many patients tend to become anxious, and panic as things do not turn up as they have expected. As I have mentioned earlier, if you have strictly followed the advice, the healing phase will start, and you will appreciate the improvements happening slowly. There will be symptom-free episodes in between, and it is crucial that you continue to follow all the precautionary measures and make it a part of your lifestyle. Any laxity can further resurface the problem and create trouble, which becomes very difficult to treat. I hope this helps.

Hello,

Welcome back to icliniq.com.

All fried items and anything too oily should and must be avoided. As I said, you need to observe where your diet is going haywire and correct it immediately. A general guidelines can be given and it is more important for you to assess which food item is troubling you more. Tea, sweets, milk in empty stomach are all triggering factors. Excessive protein supplements are not recommended. Gym after a meal is a big no.More than medications, it is the precautionary measures which are more important. So please focus on that and start the medications as well.