What Causes Left Side Throat Irritation In A Patient With GERD?

Posted on Wed, 10 Jun 2015

Question: Hello Doc,
I am aged 40 Male, 87Kgs and Married. I have been suffering from GERD for a long time now ( around 5 years). I have this acid feeling coming to my buccal region when lying. There is difficulty in my swallowing for the past 4 years. All my reports , 2 times Upper EGD( one in sep 11 and 2nd in Dec 13) were OK and Laryngoscopy(Jan 14) is also normal. I have also done 24hr PH reflux and Esophageal Manometry which showed high ACID content .

For the past 1 years , I am having irritation type of feeling only on my left side of throat, that remains constant all the time.. Though not painful, but keeps me irritated all the time. A type of sore throat feeling. Left nostril also seems blocked. I twice visited ENT specialist and he said this might be allergy...
All the physicians and Hospitals I visited are renowned and none of them can cured me.

I used to smoke for the past 10 years. Not too much(5-7 cigg/daily) but have stopped it. Now I take very occasionally. This constant irritation troubles me and I cannot concentrate completely. I am very angry these days and yes I am anxious and stressed type of person. ALways stressed.

Please help me.

Answered by Dr. Dr. Klerida Shehu (1 hour later)

Brief Answer:
Dosage of PPIs to increase&diet&lifestyle modifications

Detailed Answer:
Hi,

I have gone through your medical history carefully and understood your concerns.

The consistent throat soreness is due to reflux. I would like to know about your current medication and dosage? To my opinion, you should start to use :
-PPI's like pantoprazole(with prescription),omeprazole or Prilosec OTC(If you are on treatment please double the dosage)
- antacids

I would like to recommend to change your lifestyle and diet like:
-avoid coffee, chocolate, tea, alcohol, smoking.
-eat often and small meals
-eat 3-4 hours before you go to bed
-use two pillow when you lay down
-try to lose weight
-avoid unnecessary stress

Hope it helped!
Dr.Klerida

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Dr. Klerida Shehu (2 hours later)

Thank you Doctor Klerida..

I am not taking any medicines regularly these days. I used to take Rablet 20 before dinner and Rablet It before breakfast for two months and then stopped. I used to take as and when I feel heavy GERD these days... Cigg i have stopped almost.

Doc few questions please:

1) Why do i feel tightness inside neck and particularly left side. Dry throat type and feels sticky sensation. The soreness feeling i have felt for past year only.

2) Do I require any further evaluation , tests , etc ( like CT chest, CT neck) etc.

3) I heard that neck muscles get tightened if GERD is continuous. Is it true. Can this be a case in myself.

4) Esophageal exercises were prescribed to me.. Should I do it regularly.

5) Do i have to take these medicines for life long..

I forgot to mention earlier, there is small hiatal hernia also evaluated during my EGD.

The negative feeling of having something serious in the throat always keep me stressed these days. I am not enjoying life.

Thanks once again.

Regards,
XXXX

Answered by Dr. Dr. Klerida Shehu (19 hours later)

Brief Answer:
Following answer to your queries...

Detailed Answer:
Dear XXXXXXX
Thank you for giving me more medical data.

With regard to Rablet It is a good choice to treat GERD. you should start it again 20 mg twice a day in order to relief your symptoms.

1. You are experiencing tightness on your neck, due to acid reflux on pharynx and your mouth and inflammation that follow. GERD is causing a chronic inflammation of pharynx and oral cavity that cause your symptoms.

2. You don't need to do any special examinations like CT of chest and neck. The examinations you need are chest x ray, and direct laryngoscopy.

3. This can be true in theory only in severe and untreated cases. In your case is only chronic inflammation as I said above.

4. Yes esophageal exercise are of help in your case and should be done regularly as ordered from your doctor.

5. You should take this treatment for two months and after that it depend on your symptoms. If the symptoms disappear you may lower the dose to one tablet per day for another 4 weeks. Hiatal hernia is aggravating your symptoms and you will require a longer (than usual) treatment

Hope this was of help!
Wish your health!
Dr. Klerida

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Above answer was peer-reviewed by : Dr. Shanthi.E