Many people complain that their food is not being digested, that they have heartburn, or that food seems to come back up towards the throat. This uncomfortable problem is called reflux.

Reflux is a Greek word meaning backward flow. Instead of moving down, the contents of the stomach come back up towards the throat. When we eat, food goes to the stomach and digestion begins; when it comes back up into the throat instead of being digested, that is reflux.

Advice on what to do comes from Prof Dr Zahir Al-Amin, ear, nose and throat specialist and surgeon at Impulse Hospital.

Not everyone with reflux has heartburn or indigestion. Many people with reflux in the larynx and throat have no heartburn, which is why laryngopharyngeal reflux is called silent reflux, and it can sometimes be hard to detect. Symptoms can include:

• repeatedly clearing the throat;
• increased mucus in the throat;
• difficulty swallowing food, water or pills;
• coughing after eating or lying down;
• difficulty breathing or the breath stopping;
• a troublesome or irritating cough;
• a feeling of something stuck in the throat, or of something like a tumour in the throat;
• heartburn, chest pain, indigestion, or sour water coming up with belching;
• difficulty swallowing.

A feeling of a lump in the throat is a common problem linked with laryngopharyngeal reflux, called globus pharyngeus. Some say something is pressing in the throat, or that mucus has built up that they cannot clear by coughing. Many think they have throat cancer, but this is not always a sign of cancer, and the worry can intensify the feeling. Globus means a discomfort in the throat that is not caused by a tumour or cancer.

A long-lasting hoarse voice, repeated throat-clearing and coughing, with a lump-like feeling in the throat or difficulty swallowing, are the symptoms of laryngeal or throat reflux. Some have heartburn; some have a voice that goes hoarse and then suddenly recovers; some have excess mucus; some feel as if they are choking when lying down. There is nothing to worry about, as it is not serious. But anyone with these symptoms, especially a smoker, should see an ENT specialist to find the cause.

The specialist will examine the throat and larynx closely and may perform a throat endoscopy. This differs from a stomach endoscopy: the tube is very thin and is passed through a numbed nose, so there is almost no pain or discomfort.

In most cases treatment lasts for a while, from months to years. It must be repeated if the condition returns, and some people need it all the time. Laryngopharyngeal reflux (LPR) causes no serious complications, the article says, but it also says that if left untreated it can become serious and dangerous. For those who do not respond to medicine, anti-reflux surgery is needed, and those who have it stay free of LPR for many years.

Treatments include:

• changing diet to reduce reflux;
• medicines to reduce stomach acid;
• surgery to stop reflux.

With changes in diet and lifestyle, together with some medicines, LPR is easy to treat, and surgery is rarely needed.

• Do not wear very tight clothes, especially around the waist.
• Eat low-fat food. Avoid butter, beef and mutton, eat less fried food, cut out cheese, chocolate and pastries, and do not drink citrus drinks.
• Lose weight if overweight.
• Do not drink alcohol.

Source: Amader Shomoy. First published in Bengali on The Agro News.