Response:

Many factors cause pharyngitis, but the most common are cold or flu viruses. In some cases, acid reflux can be a cause. Pharyngitis due to reflux tends to last more than 10 days.

Acid reflux occurs when acid, pepsin (a digestive enzyme produced in the stomach), and sometimes bile, flow from the stomach up into the esophagus and reach the throat. The throat lining is thin, sensitive, and lacks protective mechanisms against acid, making it vulnerable to damage. Prolonged contact of acid and pepsin with the throat lining breaks down its natural protective layer, causing inflammation, swelling, and irritating sensory nerves.

Pepsin can linger in the mucous membrane for hours and reactivate in an acidic environment. This irritation leads to typical symptoms such as persistent sore throat, hoarseness, intermittent dry cough, a sensation of a lump or thick phlegm in the throat, and frequent throat clearing. If this condition persists, the throat lining and vocal cords are at risk of thickening, forming granulomas, polyps, tonsil hypertrophy, or laryngeal tumors.

Acid reflux causes a burning sensation in the throat. Photo created by AI

Unlike common pharyngitis, reflux-induced pharyngitis does not cause fever or significant phlegm production, and it can last for weeks to months. Symptoms often worsen after a full meal, when lying down, or after consuming alcohol or coffee. Chronic inflammation can also spread to nearby organs, leading to laryngitis, sinusitis, otitis media, or triggering asthma attacks in individuals with underlying respiratory conditions.

You should consult an ear, nose, and throat (ENT) specialist if you experience a sore throat, hoarseness, or dry cough lasting more than two to three weeks without a clear cause, especially if symptoms worsen in the morning or after eating. For diagnosis, a doctor will examine your throat and larynx, possibly combining this with an endoscopy to observe the extent of inflammation, swelling, mucosal thickening, or signs of acid damage. In some cases, gastroscopy or impedance-pH monitoring may be necessary to assess the degree of reflux and esophageal inflammation. Once the cause is identified, the doctor will develop an appropriate treatment regimen.

To treat reflux-induced pharyngitis, you must first modify your lifestyle: avoid overeating, do not lie down immediately after meals, limit acidic, spicy, and fatty foods, reduce alcohol and coffee intake, maintain a healthy weight, and elevate the head of your bed when sleeping.

A doctor may prescribe acid-suppressing drugs, antacids, prokinetics, or medications to protect the throat lining, typically for at least 8 weeks, depending on the extent of mucosal damage. If medical treatment is ineffective, or if the patient exhibits severe acid reflux with a large volume of refluxed fluid, frequent vomiting, or lower esophageal sphincter (LES) dysfunction (where the lowest muscle connecting the esophagus to the stomach cannot close tightly, allowing stomach contents to reflux into the esophagus), surgery may be considered.

Master of Science, Doctor Nguyen Chi Trung

Department of Ear, Nose, and Throat

Tam Anh General Hospital Hanoi