Hi

Thanks for posting the query

After going through the history, I do feel your mother is having laryngo-pharyngeal reflux secondary to gastro-esophageal reflux disease.

Gastroesophageal reflux disease, commonly referred to as GERD or acid reflux, is a condition in which the liquid content of the stomach backs up or refluxes into the esophagus. The liquid that enters the esophagus (regurgitation) can damage the lining of the esophagus although visible signs of inflammation occur in a minority of patients. The regurgitated liquid usually contains acid that is produced by the stomach.

The reflux usually happens more in the night while lying down in supine position. Acid when it regurgitates from the stomach into the esophagus and into the throat, the mucosa of the throat gets burnt leading to inflammation of the throat. Inflammation of the mucosa in turn induces swelling giving rise to foreign body sensation, breathing difficulty, cough, repeated swallowing, excessive collection of phlegm (to soothe the inflamed area), hoarseness or tiring of the voice after speaking for few minutes, etc.

The causes of reflux of acid are many, medicines, obesity, stress, food habits, smoking, alcohol, debilitated conditions, etc. Identifying the causative factors and avoiding them can give relief from this problem.

My suggestions to your mother are:
1. To drink plenty of warm water
2. Avoid coffee/alcohol/stress/retiring to bed immediately after taking food.
3. Try taking medicines such as proton pump inhibitors (Esomeprazole,
Pantoperazole) and prokinetics (Domperidone).
4. To lie down on semi-prone position and preferably on the left side.
5. There should be gap of at least 1 hour after taking the supper and retiring to bed. This is the transit time required for the gastric emptying.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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Hi

Thanks for writing back

The traces of blood are due to rupture of the minute blood capillaries when your mother tries to clear her throat in order to bring out the sputum. This is not an indication of cancer or TB.

Secondly, the sensation of 'sweet throat' could be due to the presence of thin layer of sputum in the back of the throat following throat inflammation.

Do not worry! These are not the signs of cancer or any serious disorder. If there were to be any signs of cancer, it could have been noticed while doing the OGD scopy. If you are still very apprehensive, you can get an MRI of the neck and the upper thorax done to rule out any subtle malignancy.

I wish her good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

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