When you've got a nagging tickle in your throat or a hoarse voice, you're probably not thinking of your stomach as a possible cause -- but it might be. You've likely heard of acid reflux and the typical stomach symptoms associated with it. But frequent reflux also sometimes mimics other conditions and can cause a variety of throat symptoms, from a mild tickle causing you to clear your throat to difficulty swallowing.
Throat Clearing and a Lump Sensation
Occasional reflux and related heartburn symptoms can happen to anyone. But if reflux happens frequently, you may develop other symptoms related to stomach contents coming back up the esophagus, or swallowing tube, and into the throat. Even if you don't have typical heartburn symptoms, you may have throat symptoms. Throat clearing is one of the most common symptoms related to acid reflux in the throat. Acidic stomach contents that reach the throat and/or voice box irritate these tissues, triggering the urge to clear your throat. Tissue swelling that can occur with reflux may also cause the sensation of a lump in your throat, again stimulating the feeling of needing to clear your throat.
Cough and a Bitter Taste in Your Mouth
A bitter taste in your mouth and/or a persistent cough with no obvious cause can also occur with acid reflux disease. The bitter, unpleasant taste stems from stomach contents reaching the back of your mouth. Even the small amounts can trigger this bitter taste. A cough -- usually a dry cough -- may also develop as stomach contents irritate your upper airway. Coughing may be more frequent after large meals or after drinking alcohol, coffee or another caffeinated beverage. Some people also experience more coughing at night.
Sore Throat and Hoarseness
Some people with acid reflux disease experience a persistent sore throat and/or hoarseness. You may even think you have strep throat or a recurrent viral infection, but the absence of fever and other symptoms can help clue you in that you probably don't have an infection. Throat pain and hoarseness associated with acid reflux disease may stem from swollen, irritated tissues, but it can also be caused by throat clearing and coughing, which can also irritate the vocal cords and throat. Hoarseness caused by acid reflux disease is often worst in the morning.
Difficulty Swallowing and Warning Signs
If the swelling and irritation caused by reflux becomes severe enough, you may have difficulty swallowing. If left untreated, acid reflux may cause changes in the lining of the lower and esophagus over time. These changes may affect your swallowing.
See your doctor as soon as possible if you experience difficulty swallowing or breathing; chest pain; hoarseness or a cough lasting more than 2 weeks; weight loss with your throat symptoms; or coughing up blood.
Is This an Emergency?
- American Academy of Otolaryngology -- Head and Neck Surgery: GERD and LPR
- American College of Gastroenterlology: Diagnosis and Management of Gastroesophageal Reflux Disease
- American Academy of Otolaryngology -- Head and Neck Surgery: Laryngopharyngeal Reflux
- Family Practice Notebook: Gastroesophageal Reflux
- JAMA: Evaluation and Management of Laryngopharyngeal Reflux