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Had Cough And Feel Lump, Need To Clear Throat. Esophogram Showed Mucosal Abnormality And CT Scan Showed Stenosis

Posted on Sun, 29 Sep 2013

Question: when I eat usually crunchy food I find that a cough and need to clear my throat. was feeling a lump in my throat for weeks now lump is gone. Had esophogram and ct throat scan. the esophogram showed mucosal abnormality by c4. the ct scan show stenosis and bone spurs in neck.
taking acid reflux meds for 4 months now switched few weeks ago from ppi omeprazole to h2 blocker ranitidine med.
What can this be?

Answered by Dr. Amit Jain (6 hours later)

Brief Answer:
get endoscopy, take PPI with domperidone

Detailed Answer:
Hello! Thanks for putting your query in XXXXXXX I am a Gastroenterologist (DM).

I will advise you to get an endoscopic examination which will confirm what is the abnormality. it may be simply feeling of foreign body sensation or globus pharyngeous which all may be due to GERD (that is reflux disease). And for GERD take a proton pump inhibitor like rabeprazole or pantoprazole which are better than ranitidine. Also take a prokinetic agent like domperidone which will further help in relieving your symptoms. Few more tips regarding GERD

1.Avoid fatty meals
2. Don’t lie down soon after meals for at least half hour
3.Take small and frequent meals, instead of full meals at a time
4. wear loose clothes
5. If you are overweight or obese do weight reduction with dieting and exercise

I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Amit Jain (17 minutes later)

Could it be larygophareneal reflux or lpr? If so would endoscopy be able to detect this, I've been reading that it wont

Answered by Dr. Amit Jain (12 minutes later)

Brief Answer:
Please see details

Detailed Answer:
Hello! thanks for feedback.Endoscopy will be helpful as larynx is equally visible during endoscopy if one looks for that, one may find inflammed vocal cords although laryngoscopy will be better for this. Also one can find changes in oesophagus to confirm GERD during endoscopy.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Amit Jain (32 minutes later)

I was on omeprazole but upset my stomache and gave me loose bowel movements, doctor switched me to milder form ranitidine . I also have a tickle in the back of throat. That makes me cough and clear my throat. I read on line about the 24hr ph test, wouldn't that also be recommended for lpr?

Answered by Dr. Amit Jain (45 minutes later)

Brief Answer:
24 hrs pH with manometry is the best test

Detailed Answer:
Hello! Thanks for feedback.

Yes you are right 24 hrs pH with impedence monitoring is the best test for confirming GERD.

If you have GERD with nocturnal cough it suggest that it is due to LPR only. For this you have to keep your head end elevated while sleep to prevent nocturnal reflux, wear loose clothes, avoid fatty meals and keep a gap of at least 2 hours between meals and sleep.

No loose bowel movements is not the side effect of omeprazole in such a small duration of four months only, it must be something else.

Wish you a good health

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar