Q. What causes throat pain with breathing difficulty?

Answered by
Dr. B Vageesh Padiyar
and medically reviewed by Dr. Divya Banu M
This is a premium question & answer published on Jul 14, 2020 and last reviewed on: Aug 01, 2020

Hello doctor,

I have an issue. I am feeling pain in the throat on either sides. More than throat, it is neck, lower neck, not midline, on either side no pain on swallowing but I have to take some deep breaths occasionally.

#

Hi,

Welcome to icliniq.com.

The most common reason of having these symptoms can definelty be a feature of chronic silent GERD with LPR (gastroesophageal reflux with laryngopharngeal reflux). Even though you might asymptomatic as far as gastric issues are concerned, the inflammation in the throat often exists in the hidden form and can resurface when adequate care is not taken.

Now, why does hidden acid reflux become so problematic? As you know the stomach usually has got cells which release hydrochloric acid and thus keep the gastric environment acidic in nature. Your entire mucosal lining from the mouth throat and food pipe (oesophagus) is not meant to handle any thing 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 and cold food/drinks.

3. Keep a gap of 2 hrs between meals and going to bed

4. Don't 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.

Treatment plan:

Tablet Pan D 40 mg (or its equivalent) once in the morning before breakfast for 1 month. Syrup mucaine gel (or its equivalent) 1 teaspoon three times a day 20 minutes before meals for 1 month. Make sure you follow the precautionary measures as much as possible as mere medications will not fetch long term relief. This typically takes 2 to 3 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 entitity and things will be fine in few weeks duration.

Thank you doctor,

It sometimes leads to some discomfort in the ears also and I feel somehow it is related to the problem in the throat and neck region. One in the ears is not very serious and happens for a few minutes ocassionally but is it related? Another doubt I have is if the respiratory issue associated with this is going to be long lasting or is it reversible?

#

Hi,

Welcome back to icliniq.com.

Wonderful to hear from you again.

The throat and the middle ear promontory share the same nerve supply: the glossopharyngeal nerve or the 9th cranial nerve. If you go deep into the anatomy, you will see that the branch of the glossopharyngeal nerve supplying the middle ear compartment is called the jacobsons nerve.

This is the reason why sometimes the discomfort is often referred to the ear when there is nothing as such related to it. The respiratory issue is purely due to gerd and lpr which causes sudden spasm of the laryngeal musculature and that is why you suddenly feel your out of breath or feel there is some kind of tightness in your chest. It is definitely a reversible entity and things should come back to normal once measures discussed earlier are followed for as long as possible. As i mentioned earlier, this entity typically takes a while to improve but at the same time you should also note that things can back to square one much faster than it took to heal. This is the reason why we usually advice patients to maintain the modified changes in lifestyle for as long as possible and not keep a time frame. I personally dont like giving medications for a very long time considering its side effects however small or negligible it might be.


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