Most people who experience the sensation of a lump in the throat, sore throat, and cough assume they have a cold or cough. These common viral infections are so perva-sive and mild that they don’t require treatment, while some patients will take over the counter medications to ease symptoms. However, these same symptoms can be a sign of GERD, a much more serious disease.
Although GERD can be treated if diagnosed quickly, if GERD is ignored serious dam-age can be done to the esophagus. In the long term, GERD patients are much more likely to develop Barrett’s esophagus or esophagitis. The lining of the esophagus changes due to exposure to stomach acid, and a strong connection between this kind of tissue change has been made with esophageal cancer.
Many of the symptoms of GERD are easily identifiable. In fact, diagnosis of GERD is usually done with only a description of symptoms. The difficult part is connecting all the symptoms together to form a coherent picture of GERD. Because symptoms like the sensation of something being stuck in the throat are common to other diseases, it is the combination of symptoms that is important.
Symptoms of GERD include chronic acid reflux, chronic cough or clearing of the throat, sore throat, chest pain, neck and back pain, regurgitation, tightness in the throat or chest, asthma-like symptoms of a closing throat, and congestion. GERD can be the cause of any or all of these symptoms, in any combination.
GERD is a disease of the upper digestive system. Heartburn is usually the telling symptom, however it has nothing to do with the heart except for the location of the pain, in the center of the chest, just below the breast bone. The pain is caused by stomach acid that has come back up into the esophagus, the tube that connects the mouth to the stomach. When you swallow, the food travels down the esophagus and then is allowed through to the stomach by a muscle called the lower esophageal sphincter (LES). It is the LES that is usually responsible for GERD, as the job of the LES includes closing once food is through to the stomach.
The malfunction of the LES allows stomach acid and bits of food to enter the esopha-gus. Stomach contents are incredibly acidic, as the function of the stomach is to brake down foods using acids. The stomach lining secretes mucus to protect it from the acidi-ty. However, in GERD patients the acidity of the stomach is higher than normal, and while the stomach can compensate, the esophagus cannot. The esophagus can also secrete mucus to protect itself, but because it is not normally exposed to high acidity, it is much less effective.
Highly acidic stomach contents cause the burning sensation in the chest, and are re-sponsible for the discomfort associated with GERD. Infrequent heartburn, less than once a week, is usually due to a highly acidic diet or poor eating habits, like eating quickly and stuffing oneself. The danger of GERD comes when it is ignored and heart-burn occurs once a week for a few weeks in a row, or even more frequently. Some GERD patients report feeling heartburn every day.
The sensation of having a lump in the throat is also caused by the malfunction of the lower esophageal sphincter, if less directly. When highly acidic stomach contents are allowed into the esophagus, they can also travel up into the throat and even the mouth. Stomach acid even finds its way into the nasal cavity. Wherever the stomach acid is present, the membranes around it will create mucus and become irritated. Sore throat and congestion can result, as can the sensation of having a lump in the throat on a regular basis.
Diagnosis and Misdiagnosis
If you are experiencing the sensation of having a lump in the throat on a regular basis, contact your doctor about an appointment. Carefully note symptoms, especially the tim-ing in relation to meals or exercise. Note frequency and duration of each occurrence. It is also very important that you note any other symptoms, in fact all symptoms, whether you think they are related or not.
Your doctor will try to diagnose your condition based on the description you provide of any and all symptoms. Allow your doctor to decide whether symptoms are related and report anything that is troubling you. The best way to ensure you are giving accurate information is to write down everything you can about symptoms and bring the notes to your doctor.
Misdiagnosis of GERD is common. When patients only experience cold or cough symptoms, their doctor will not be able to identify them as caused by GERD. There are some telling factors that will help with diagnosis, in particular the timing relating to meals. GERD symptoms are most likely to occur just after a meal, or within 30 minutes of eating. Symptoms will also be relieved by the use of an over the counter antacid.
If your symptoms do not respond to an antacid, it is possible you are experiencing symptoms of a much more serious disease or condition. Never hesitate to call 911 if you have chest pain, shortness of breath, sensation of a lump in the throat, and dizziness or disorientation. These are symptoms of heart attack. If symptoms occur after exercise and are relieved when you relax, you may be suffering from a condition called angina, a partial blockage of an artery. This is also a very serious condition that requires immediate attention.
Treatment and Prevention
If you experience a sensation of having a lump in the throat on a regular basis, and your doctor can diagnose you as suffering from GERD, your doctor will attempt to treat the GERD. This may require your participation, as GERD can be cured with changes to diet and eating habits.
Your doctor can give you a list of foods that may trigger GERD, but common foods in-clude spicy foods, fatty foods, highly processed foods, tomatoes, potatoes, eggplant, onions, garlic, and citrus. These foods are high in acids themselves, or require a lot of stomach acid to brake them down. Foods and beverages that contain caffeine, nicotine, and alcohol are also likely to trigger symptoms, as they irritate the lower esophageal sphincter and increase the acidity of the stomach
If your symptoms are well documented, you may be able to identify what triggers them yourself. Each case of GERD can be slightly different, and by noticing what causes symptoms, you can learn to avoid the foods and drinks that give you heartburn and other symptoms.
The best way to avoid GERD and its symptoms is to eat a healthy diet, eat slowly, breathing between bites, and never overstuff yourself. Anything that causes the sto-mach to produce extra acid or puts pressure on the stomach or chest should be avoided. And never lie down after a meal, or bend over, as gravity will then put pressure on the stomach contents to move in the wrong direction.