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Hello and welcome,

Throat irritation and feeling like you have a lump there, can be from post nasal drainage (from an upper respiratory infection or allergies) or from acid coming up from the stomach. Given that yours seems to be getting better, and has correlated with congestion and sneezing, and as you've never had GERD before, it seems most likely that this is from drainage going down the throat.

If you want to try an acid reducer without knowing for sure if acid coming up is the problem, I recommend Zantac (ranitidine) 150 mg twice a day or 300 mg at bedtime, rather than Nexium. My reason for this is that Zantac is an overall safer medication than the proton pump inhibitors, which Nexium is. Proton pump inhibitors have the potential for increased acid production on discontinuation of the medication, and also more side effect risks (cardiac). Zantac is an H2 blocker and decreases the amount of acid too, but using a different mechanism. Use it for a few days and see if it helps.

You note that the lump feels like it is getting smaller. If it doesn't resolve entirely in the next several days, then I recommend you go in to be seen and have something called indirect laryngoscopy done. This is simply looking down to your vocal cords with a light and the type of mirror dentists use. The mirror doesn't touch you, it just reflects the image from the back of the throat. I recommend follow up if the lump doesn't go away as it could be unrelated to acid reflux or a viral upper respiratory infection.

I hope this information helps. Please let me know if I can provide further information.

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Yes, this additional history does make acid reflux into the throat more likely than before. I would still try the Zantac and give it a few days to see if it does the trick.

Also, while this stomach issue is happening, avoid alcohol, decrease caffeine, no peppermint (it can relax the lower esophageal sphincter making GERD more likely), decrease citrus, tomatoes, and highly spicy or greasy foods. Avoid eating within a couple of hours before going to bed. And avoid large meals (these distend the stomach and increase acid production and GERD risk).

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Hi XXXXXXX

Well, you don't have a fever, but I am wondering about the accuracy of your thermometer, because core body temperature doesn't usually change that much that quickly. It could have been from different placement under your tongue too.

If the Zantac is helping for both the lump in the throat and the belching, then the problem is highly likely to be from stomach irritation and acid reflux.

Zantac decreases acid production by around 70% which allows the lining of the stomach and/or lower esophagus to heal, while still allowing for enough acid to digest food.

Take it for a couple of weeks and then see how you are doing. If the lining needs to heal, 6 weeks is recommended.

You should see continued improvement in symptoms over the next two weeks. If, however, the improvement is not enough, then do talk with your primary doctor when you see him/her for your check up next week.

In the meantime, avoid or decrease the foods I wrote about in the previous email (above) and avoid large meals and eating within a couple of hours before bed or reclining.

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Yes, of the acid reducing medications, Zantac is quite safe. It is ok to take it for several months. When on the Zantac, hopefully you will not need the antacids.

If your symptoms persist, your doctor and you may want to consider a prescription strength proton pump inhibitor. But in many situations, Zantac will do the trick.

And yes, your opinion does matter very much! It's your body, after all, so you have the most experience with how it reacts to different things.

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