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Ear, Nose, and Throat Disorders

Sore throat for 6 weeks

02/05/2007

Question:

I am a healthy, 33 year old female. For the past 6 weeks weeks I have had a sore throat, not the sore throat that you need a cough drop or strep throat. This feels deep in my throat down below the adams apple/tracheae area. It feels like someone is pushing in the middle of my throat, tight, swollen and difficult to swallow. The tightness and swollen/pain feeling is there constantly, never subsides. The difficulty swallowing is worse for saliva, but somewhat helps when I drink hot/warm tea. They thought I had strep throat and gave me Keflex, didn’t work. Then they did blood work and said I had a upper tract infection and gave me Medrol and Avelox, didn’t work. Then I went to an ENT, he scoped me in the office down the nose into the throat, nothing. I had a barium swallow, nothing. This has been here for 6 weeks, all day/night. He suggested its acid reflux without heartburn. I have no stomach symptoms though. He gave me a prescription called Omeprazole, but I haven’t taken it yet. Any advise is greatly appreciated…

Answer:

Acid reflux without heartburn is common.  The term is laryngopharyngeal reflux (LPR) and can cause symptoms such as sore throat,  cough, hoarse voice, and a feeling of a lump in the throat.  One doe not need classic heartburn symptoms to have LPR.  This is likely due to the sensitivity of the larynx compared to the esophagus for acid.  Acid suppression medications often help.  Typically, patients are started on once a day PPI's such as omeprazole for one month, if there is no improvement than twice a day therapy for three months is necessary.  It can take up to 3-6 months for complete resolution in some patients.  If symptoms have not improved in three months than a transnasal esophagoscopy is warranted to rule out esophageal pathology.

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Response by:

Lee   Zimmer, MD Lee Zimmer, MD
Assistant Professor or Otolaryngology, Director of Endoscopic Cranial Base Center
College of Medicine
University of Cincinnati