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ENT Conditions > Throat

Gastro-oesophageal Reflux

In some people, stomach acid or its contents may come up in to the throat and/or gullet connecting the throat to the stomach. This may occur at any time day or night but is most common after meals and lying down.

Some of the symptoms that may occur from this include recurrent coughing, sore throat, heartburn or indigestion, hoarseness or changes in the voice, constant throat clearing, excessive mucous or post nasal drip, a bad taste at the back of the mouth, or a sensation of a lump in the back of the throat. The following instructions are designed to help neutralise the stomach acid, reduce the production of acid, and prevent acid from coming up the oesophagus or gullet. You should adopt enough of these suggestions to get relief of your symptoms. It is important to realise, however, that healing of the irritated oesophagus and throat will take time and one should allow four to six weeks minimum of careful treatment before expecting results and relief from symptoms.

Posture

Obesity is a significant factor in promoting reflux of stomach contents. One should avoid clothing that fits tightly across the mid section of the body, avoid slumping, bending, or stooping as much as you can.

For many people, acid reflux occurs mostly at night and sets up the irritation which continues to bother during the day time. One of the most important things you can do is to sleep on a bed which is elevated at the head end. To do this, use wood or bricks or even telephone directories underneath the legs at the head of the bed. The elevation should be 4 -10” but not so high that you will slide down when sleeping. The use of pillows to get the head up is not effective because they cause the body to curve and it is difficult to remain upright on them all night. Further more, pillows promote sleeping on the back but it is preferable to sleep on the right side or on the stomach since this will allow gas to escape from the stomach and reduce the escape of acid material.

Antacids

These are available without prescription at your local pharmacist. Popular brands such as Gelusil or Rennes are readily available. Gaviscon is not an antacid but floats on top of the stomach acid preventing oesophageal irritation. Antacids can interfere with the absorption or certain drugs such as tetracyclines from the intestine and it is, therefore, important that patients are aware of this side effect. In the beginning, you may wish to take the antacids just at bedtime, but if symptoms are very persistent, they should be taken 45 minutes after eating, every two hours between meals, and at bedtime.

Medication which promote reflux

Several different medication may increase stomach acid. These include Progesterone, Theophylline, anticholinergics, betablockers, aspirin or aspirin containing compounds especially the group called non steroidal anti-inflammatory drugs. (Incidin or Theldine). Vitamin C is also an acid and can give stomach symptoms if taken in large doses. Tobacco also increases the amount or acid reflux. It is wise that any patient consults his or her General Practitioner before making any changes in these medications.

Diet

1. Avoid eating large meals. Eat smaller, more frequent meals rather than one or two meals per day. Sit up straight during and after eating, and do not eat for two or more hours before going to bed.

2. Certain foods are especially bothersome to the stomach and tend to cause acid production. These include caffeinated and de-caffeinated coffee, tea, carbonated drinks, chocolate, spearmint, peppermint and alcohol. These foods are known to cause relaxation of the muscle band between the stomach and the gullet, allowing the stomach acid to come up and irritate the oesophagus and throat. Many of these can also stimulate acid production, therefore, making the problem worse.

3. You should avoid any other foods which cause you to have heart burn. Certain foods which may cause heart burn are highly spiced foods, tomato and tomato products and citrus fruits and juices.