Symptoms of reflux: difficulty swallowing, sore throat, cough

Many people are familiar with the discomfort of reflux disease: the burning sensation behind the chest, the sour taste in the mouth. But did you know that reflux is much more than just heartburn? Difficulty swallowing, a persistent sore throat and a persistent cough can all be symptoms that may be behind reflux disease. However, these signs can be easily misunderstood or ignored, and recognising and treating them early is key to staying healthy.

In this article, you can learn about the lesser-known symptoms of reflux, find out about the serious complications that can result from untreated reflux, and how the Endomedix team of experts to help you identify and deal effectively with complaints.

What is reflux disease and how does it develop?

Reflux disease (also known as GERD - gastro-oesophageal reflux disease) develops when stomach acid regularly flows back into the oesophagus. This is caused by a dysfunction of the lower oesophageal sphincter: the sphincter does not close properly, so stomach contents can easily back up.

The walls of the oesophagus are not protected by a protective layer like the stomach, so acidity can easily damage the mucous membrane. This can cause inflammation, discomfort and, in the long term, even more serious lesions.

The most common causes of reflux

• Lifestyle factors: eating fatty, spicy foods, coffee, alcohol, smoking
• Overweight: belly fat puts pressure on the stomach
• Certain medicines: for example, painkillers (NSAIDs)
• Recession: when part of the stomach is pushed up into the chest
• Pregnancy: hormonal changes and uterine pressure

Less known symptoms of reflux

Although heartburn and acid reflux are the most common complaints, reflux can present a much more varied picture. Let's take a closer look at the symptoms that are often not associated with this condition.

Difficulty swallowing (dysphagia)

Difficulty swallowing is one of the most important warning signs that should never be ignored. If you feel food „stuck” in your chest or experience pain when swallowing, this could be a sign of reflux disease.

Why does it develop?

Persistent acidity causes inflammation in the oesophagus, which can lead to swelling. In more severe cases, it can lead to scarring, stricture or even ulceration, which can mechanically block the passage of food.

When to worry?

• If the swallowing difficulty gets progressively worse
• If you have trouble swallowing solid food at first and then later also swallow liquids
• If weight loss occurs at the same time

Sore throat and irritation

Do you often find that you wake up in the morning with a sore throat when you don't have a cold? Reflux sore throat is not associated with fever or other cold symptoms, but it can be persistent and recurrent.

How is it linked to reflux?

At night, when you lie down, stomach acid flows back more easily and can reach the pharynx and vocal cords. The acidity irritates the lining of the throat, which is why you may wake up with an unpleasant scratchy feeling and hoarseness.

Typical symptoms:

• Morning hoarseness
• A scratchy feeling in the throat
• Frequent throat irritation
• Sore throat after eating
• Sound change

Chronic cough

If you've been coughing for months but your lung doctor says your lungs are fine, it's worth considering reflux. Reflux cough is dry, persistent and often occurs at night or after meals.

What causes it?

Stomach acid irritates the mucous membranes of the throat and larynx, causing a coughing fit. In addition, tiny droplets of the acid can be inhaled, directly irritating the airways.

Recognisable features:

• Dry, barren cough
• Night coughing fits
• Coughing after meals
• Traditional cough suppressants do not help
• No fever or other respiratory symptoms

What are the serious consequences of untreated reflux?

If the symptoms of reflux are ignored, the disease can worsen and lead to serious long-term complications. Let's look at the dangers of procrastination.

Esophagitis and ulcer

Persistent acidity causes inflammation of the mucous membrane of the oesophagus. This is only an inconvenience at first, but over time painful ulcers can develop.

Symptoms:

• Chest pain
• Severe difficulty swallowing (dysphagia)
• Painful swallowing (odynophagia)
• Less commonly bleeding (black, pitchy stools or vomiting blood)

Esophageal stricture

Chronic inflammation can lead to scarring, which narrows the oesophagus. This leads to progressively worsening difficulty swallowing, which significantly impairs quality of life.

What to look out for?

• Initially, only swallowing solid food is a problem
• Swallowing liquids also becomes difficult later
• Frequent backflow of food
• Weight loss due to eating difficulties

Barrett's oesophagus: a cancer-preventing condition

This is one of the most serious complications. In Barrett's oesophagus, the normal cells in the lower part of the oesophagus are transformed into a cell type typical of the stomach or intestinal tract as a result of prolonged exposure to acid.

Why is it dangerous?

Barrett's oesophagus is a cancer-preventing condition. Cellular changes significantly increase the risk of developing oesophageal cancer. That's why regular specialist check-ups and endoscopic examinations are important.

Risk factors:

• Over 50 years of age
• Male (twice as common in men)
• Overweight
• Smoking
• Reflux for more than 5 years

Other complications

Respiratory problems:

• Worsening of asthma
• Recurrent pneumonia (due to inhalation of stomach acid)
• Chronic bronchitis

Dental problems:

• Tooth enamel damage
• Increased susceptibility to caries
• Mouth and gum problems

How can reflux disease be detected?

A specialist examination is needed for an accurate diagnosis. From Endomedix gastroenterology centres, we use state-of-the-art diagnostic methods to determine the presence and severity of reflux.

Gastroscopy (gastroscopy of the stomach)

This is the most important test in diagnosing reflux disease. The thin, flexible endoscope allows the specialist to directly examine the mucous membranes of the oesophagus, stomach and duodenum.

What does the test show?

• Signs of oesophagitis (inflammation of the oesophagus)
• The presence of ulcers
• Bottlenecks
• suspected Barrett's oesophagus (tissue sample required for confirmation)

How is it done?

You should not eat or drink 6-8 hours before the test. From Endomedix-can be performed under general anaesthesia, making the procedure completely painless and comfortable.

24-hour pH measurement

This test measures exactly how much acid flows back into the oesophagus in a day. A thin probe is inserted through the nose into the oesophagus, which continuously records the pH value.

When is it proposed?

• If you suspect reflux on the basis of your symptoms but the gastroscopy is negative
• To monitor the effectiveness of treatment
• During a preoperative examination

Esophageal manometry (pressure measurement)

This test measures the function of the oesophagus, the swallowing process and the function of the lower sphincter. It also helps to rule out other oesophageal diseases.

Empirical treatment (PPI test)

In some cases, your doctor may try an anti-acid medicine (proton pump inhibitor, PPI) for 4-8 weeks. If symptoms improve significantly, this will confirm the diagnosis of reflux.

How can reflux disease be treated?

The good news is that reflux disease can be effectively treated in most cases. There are three pillars of treatment: lifestyle changes, drug therapy and in some cases surgery.

Lifestyle changes

These simple changes can significantly reduce symptoms:

Etrend:

• Avoid fatty, spicy foods
• Reduce your intake of coffee, alcohol, chocolate and mint
• Avoid excessive consumption of citrus fruits and tomato-based foods
• Eat smaller portions, but more often
• Don't eat 2-3 hours before bedtime

Body weight:

• Reducing excess weight can significantly improve symptoms
• Even a weight loss of 5-10% can bring noticeable improvements

Sleep habits:

• Raise the head end of the bed by 15-20 cm
• Sleep on your left side (this reduces acid reflux)
• Do not lie down immediately after a meal

Other:

• Stop smoking
• Avoid tight clothing that puts pressure on the abdomen
• Stress management: stress can make symptoms worse

Medication

Proton pump inhibitors (PPIs):

These medicines reduce the production of stomach acid. This is the first choice in most cases. Examples: omeprazole, pantoprazole, esomeprazole.

H2 receptor blockers:

They also reduce acid production, but are less effective than PPIs. Examples: ranitidine, famotidine.

Antacids:

They neutralise existing stomach acid. They give quick but temporary relief. They are good for occasional use.

Alginates:

They form a protective layer on top of the stomach contents to prevent acid reflux.

Important: Never start taking medication yourself without consulting a specialist. It is up to your doctor to determine the right medicine and dose.

Surgical solution

If medication does not work, or the patient is unwilling/unable to take the medication permanently, surgery may be an option.

Fundoplication:

It surrounds the upper part of the stomach around the oesophagus, strengthening the lower sphincter. It is done laparoscopically (closed), which means less pain and a faster recovery.

Don't be afraid to be tested! We can help you

We understand that the thought of gastroenterology tests can be frightening. Many people are afraid of gastroscopy, even though this test is essential for an accurate diagnosis and appropriate treatment.

The Endomedix speciality

From Endomedix gastroenterology centres, we are committed to providing our patients with the highest quality of care in a friendly and understanding environment.

What we offer:

• Anaesthesia test: Gastroduodenoscopy and colonoscopy can be performed under general anaesthesia, making the examination completely painless.
• Experienced professionals: Our gastroenterologists are highly experienced and well versed in the latest diagnostic methods.
• Modern equipment: We use state-of-the-art endoscopes that allow a more accurate diagnosis.
• Empathetic attitude: We understand your fears and will do our best to create a calm and safe environment.

Frequently Asked Questions (FAQ)

How long does a gastroscopy take?

The optimal time for a diagnostic gastroscopy is about 7 minutes. If tissue samples need to be taken or minor surgery is required, this may extend the examination by a few minutes.

Is gastroscopy painful?

Without anaesthesia, it can cause discomfort, especially despite the anaesthesia of the pharynx. From Endomedix-However, anaesthesia is available so you can sleep through the whole thing in comfort.

What preparation is required for the test?

You should not eat or drink 6-8 hours before the test. If you are taking any medication, tell your specialist as certain drugs (e.g. anticoagulants) may need to be stopped a few days before the test.

Are there risks associated with gastroscopy?

Complications are extremely rare (less than 0.1%). Possible but rare complications: bleeding, perforation (perforation of the oesophageal wall), aspiration, cardiovascular events. In the hands of an experienced specialist, the test is very safe.

How common is Barrett's esophagus?

Around 10-15% of people with reflux disease develop Barrett's oesophagus. Regular check-ups by a specialist are therefore important, especially if reflux has been present for a long time.

How long should I take anti-reflux medicines?

This varies from person to person. For mild cases, a few weeks of treatment may be enough, but for more severe reflux, medication may be needed for years or even a lifetime. The doctor will decide the length of treatment depending on the severity of the symptoms and the results of the tests.

Is reflux perpetuated?

Genetic predisposition may play a role, but lifestyle and other factors are more important. If there is a family history of reflux disease, it is worth paying particular attention to prevention and early signs.

Do not delay any longer! Your health is at stake

The symptoms of reflux disease - whether they are difficulty swallowing, sore throat or chronic coughing - do not go away by themselves. Procrastination can lead to serious, even life-threatening complications, from oesophageal ulcers to Barrett's oesophagus and oesophageal cancer.

Early detection and treatment are key. The sooner you see a specialist, the better your chances of a full recovery and avoiding complications.

When should you see a doctor urgently?

• If swallowing difficulty develops or gets worse
• If weight loss occurs
• If bloody vomit or black stools occur
• If you experience severe, persistent chest pain (in this case, you should first rule out the possibility of a heart problem!)
• If symptoms do not improve in 2 weeks, despite taking an anti-acid medicine

Next steps

• Book an appointment: Do not wait until the situation worsens. Make an appointment with Endomedix gastroenterology centre today.
• Get ready for the consultation: Describe your symptoms, their frequency and what triggers or relieves them.
• Bring your previous toys: If you have already had a gastroenterological examination, bring the previous results with you.

From Endomedix experienced specialists and modern diagnostic procedures to help you get an accurate diagnosis and the right treatment. Our aim is to help our patients regain their quality of life and get rid of the discomfort caused by reflux.

Your health is the most important thing - do it today! Contact us and start your journey to a complaint-free life.