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Ear, Nose, and Throat Disorders

Dry, scratchy throat with swallowing tightnes

07/30/2001

Question:

I have the following throat problems: 1)Scratchy feeling in the back of my throat especially when I wake up. 2)A tightening in the throat as the day progresses. 3)Difficulty swallowing (like a lump in the throat and scratchyness as the food passes down my throat)as the day progresses. Usually in the morning no problems while eating. 4)Throat spray at night burns a little then seems to take away the symptoms. 5)I clean my teeth and mouth after ever meal and gargle with mouthwash. This seems to aleviate the symptoms for a while. 6)When I wake up my throat feels its best usually without problems except maybe for a dry sratchy feeling in the back of the throat. 7)This has been with me for a long time. I thought it would go away with the cold I had but it did not. 8)Sometimes when I want to burp I can`t. The burp seems to get hung up on its way out.

My doctor gave me 10 days of antibiotics and it has not cleared up the problem. I do get bedsweats around my shoulders and head since I`ve been on the antibiotics. I`m HIV negative. I hope you can give me a good idea what this might be!

Answer:

Your symptoms sound very much like acid reflux. It sounds as if your symptoms have been on going for many months, if not many years. Most patients with acid reflux, severe enough to cause throat complaints, do not complain of heartburn or indigestion. I often find that many of the patients that I see for throat manifestations of acid reflux will give an antedating history of indigestion or heartburn severe enough that they used to carry Rolaids or Tums in their pockets all the time. Acid reflux is a chronic condition that is best characterized as a lifestyle disorder. I do not believe that it is a true disease. This is a condition that could be better if people lose weight, don`t eat prior to laying down, eliminate or reduce caffeine, cigarettes, chocolate, citrus fruits and in some cases alcohol. This is not to say that all people will have problems with all of these substances. The best way to figure out if you are having a problem is to become a diet detective. Start eliminating certain foods from your diet. Then reintroduce them to see if you have problems. The problems may be heartburn, indigestion, frequent throat clearing, difficulty swallowing, chronic cough, occasional hoarseness, a sensation of a lump in the throat, waking with a choking sensation or a burning or acid taste in the throat. Acid reflux is often treated with acid reducing or acid blocking medications. You need to make sure that there is no kind of tumor mass in the throat. The best advice for you is to see an Ear,Nose and Throat doctor because we are the only doctors that are trained to look at the vocal cords and lower throat. I hope I have been able to provide you with some useful information. Good luck in getting this problem solved.

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Response by:

Keith M Wilson, MD Keith M Wilson, MD
Associate Professor of Otolaryngology, Director of Head and Neck Division
College of Medicine
University of Cincinnati