Every morning you have a scratchy throat after spending the night coughing. Spontaneously, you think you have contracted a virus or are the victim of respiratory allergies. However, there is another cause, less known, which could explain your symptoms.
Laryngopharyngeal reflux: this “silent” disease
“It is not uncommon to confuse allergy, rhinitis and gastroesophageal reflux disease (GERD)” confirms Dr. Gérald Kierzek for True Medical. The reason? “Reflux can give ENT symptoms (cough, throat clearing, hoarse voice, mucus, etc.) very similar to rhinitis or an allergy.“, he explains.
This is what specialists call laryngopharyngeal reflux or “silent reflux”. Unlike classic GERD, it is not always accompanied by typical heartburn. In this mechanism, acid travels past the esophagus to the larynx, pharynx, and sometimes even the sinuses, causing repeated infections and a feeling of a lump in the throat.
Why is confusion so common?
The overlapping symptoms make the diagnosis complex. Allergy and rhinitis cause a runny nose and a scratchy throat, signs that are exactly the same as reflux.
Dr Kierzek highlights a real vicious circle. “Irritation of the mucous membrane and coughing also promote reflux, which maintains the phenomenon.“.
However, one sign should alert you: if you suffer from a nighttime cough, a hoarse voice upon waking up and mucus without any real nasal obstruction or fever, and this lasts for weeks, reflux is a serious avenue to explore.
The causes: a question of pressure and valves
The passage of acid is normally blocked by two sphincters (the cardia at the bottom and the upper sphincter at the top). If the first fails, it is classic GERD; if the second fails, the acid reaches the throat.
Several factors aggravate this situation:
- Abdominal pressure: Obesity, pregnancy or excessively large meals;
- Lifestyle: Tobacco and alcohol reduce the tone of the sphincters;
- The mechanics: Hiatal hernia or slow gastric emptying;
- Medications: Certain antihypertensives or sedatives can promote these rises.
Treatments and solutions: how to get out of it?
To confirm the diagnosis, doctors sometimes offer a “test treatment”. Antacids and alginates are then used to form a mechanical barrier, or proton pump inhibitors (PPIs) to reduce acid production.
Beyond medications, lifestyle measures have proven their effectiveness.
- Lose weight if you are overweight;
- Stop smoking, which increases reflux;
- Eat a light dinner and wait 2 to 3 hours before going to bed;
- Raise the head of the bed with blocks (not just pillows) to prevent acid from rising due to gravity.
How to tell the difference?
To avoid making mistakes again, remember these key clues:
- It’s more of an allergy if you have burst sneezing, itchy eyes and rapid improvement with antihistamines;
- It’s more likely reflux if symptoms get worse after a fatty meal, coffee, or alcohol, and you feel bitterness in your mouth or better when standing.
In summary, if your “cold” drags on without fever and gets worse after meals or at night, talk to your doctor: treating your stomach could well be the key to finally freeing your throat. A simple adjustment to your lifestyle and appropriate treatment is often enough to break this vicious circle between digestion and breathing.