Kindly help me get rid of my VCD with chest and throat tightness.

Question

Hello doctor,

I have been diagnosed with vocal cord dysfunction, and I went through speech therapy seven months ago but did not get better still. I have had this for a year and a half after having COVID. My VCD is consistent with chest tightness and throat tightness. I am tired of it, and none of my exercises work. Kindly help.

Answer 1

Hi,

Welcome to icliniq.com.

Thanks for the briefing regarding the problem in concern. I had a detailed look at the observations done by the physicians out there (attachments removed to protect the patient’s identity). The most likely cause of the symptoms you have mentioned could be 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. As you know, the stomach has gut cells that release hydrochloric acid and thus keep the gastric environment acidic. Your entire mucosal lining of the mouth, throat, and food pipe is not meant to handle anything acidic. And 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 and eat on time. 2) Kindly avoid spicy and oily food and cold drinks. 3) Keep a gap of two hours between meals and going to bed. 4) Do not overeat; instead, keep your stomach half empty and have regular intermittent light foods like fresh-cut fruits in between main meals. 5) Do salt water gargling eight to ten times a day for 15 days. 6) Kindly 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. I suggest you take the following medications; 1) Tablet Pan-D 40 mg (Pantoprazole and Domperidone) once in the morning before breakfast for one month. 2) Syrup Mucaine gel (Oxetacaine, Aluminum hydroxide, and Milk of magnesia) one tablespoon thrice daily 20 minutes before meals for one month. Make sure you follow the precautionary measures as much as possible as only medications will not provide any long-term relief. Please understand that this typically takes four to six weeks for things to normalize and symptoms to subside. You need to worry about absolutely nothing as this is a treatable entity, and things will be fine. I hope I have answered your query in detail. Warm regards.

Answer 2

Hi,

Welcome back to icliniq.com.

Nice to hear from you. Tablet Pan-D is a combination of Pantoprazole and Domperidone. If this combination is unavailable, you can go for any proton pump inhibitor such as Rabeprazole and Esomeprazole. This is an over-the-counter drug and is available without a prescription. As I had mentioned earlier that you need to eat on time, I mean to say that you need to follow a particular schedule as far as food intake is concerned. Make sure you adhere to the following schedule without any discrepancies; 1) Kindly have your breakfast in the morning within three hours of waking up. 2) Go for a good brisk walk for 40 minutes on an empty stomach in the morning and evening. 3) It is best to refrain from having any packed juice, tea, and coffee on an empty stomach With these measures, the problem will undoubtedly come down with time. Warm regards.