There are many causes of sore throat, but the most common is a cold or flu virus, and in some cases it can be caused by gastric reflux. Sore throat caused by reflux tends to last more than 10 days.
Gastric reflux occurs when acid, pepsin (digestive enzymes produced in the stomach), and sometimes even bile flow from the stomach back up the esophagus and into the throat. The throat mucosa is inherently thin, sensitive, and has no defense mechanism against acid, so it is easily damaged. Acid and pepsin in contact with the throat mucosa for a long time will break down the natural protective layer, causing inflammation, edema, and stimulating sensory nerves.
Pepsin can exist for many hours in the mucosa and becomes active again when exposed to an acidic environment. This irritation causes typical symptoms such as persistent sore throat, hoarseness, intermittent dry cough, feeling of stuck or thick phlegm in the throat, and frequent throat clearing. If prolonged, the mucosa of the throat and vocal cords are at risk of thickening, forming granulomas, polyps, enlarged tonsils, and laryngeal tumors.
Gastric reflux causes a sore throat. Photos are generated by AI
Unlike normal sore throat, sore throat caused by reflux does not cause fever, does not cough much phlegm, and can last for weeks to months. Symptoms increase after eating, lying down, or drinking alcohol or coffee. Chronic inflammation can also easily spread to nearby organs, leading to laryngitis, sinusitis, otitis media or triggering asthma attacks in people with underlying respiratory diseases.
You should see an ear, nose and throat specialist if your sore throat, hoarseness or dry cough lasts more than 2-3 weeks without a clear cause, especially if symptoms get worse in the morning or after eating. To diagnose, the doctor examines the pharynx – larynx, possibly combined with endoscopy to observe the level of inflammation, edema, mucosal thickening or signs of damage due to acid. Some cases require gastroscopy or impedance pH measurement to assess the level of reflux and esophagitis. Once the cause is determined, the doctor develops an appropriate treatment regimen.
To treat sore throat caused by reflux, first of all you need to change your lifestyle, avoid overeating, do not lie down immediately after eating, limit spicy and greasy foods, reduce alcohol and coffee, maintain a reasonable weight and raise the head of the bed when sleeping.
The doctor may prescribe acid secretion inhibitors, acid neutralizers, intestinal motility stimulants or throat mucosa protection drugs, for at least 8 weeks depending on the level of mucosal damage. If medical treatment is ineffective, the patient shows signs of gastric reflux with a large amount of fluid, vomiting a lot, and lower sphincter failure (the lowest muscle of the esophagus connecting to the stomach is unable to close tightly, causing stomach fluid to reflux into the esophagus), the doctor will consider surgery.