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Birmingham, AL | ENT Specialists
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When Should You See an ENT vs. an Upper GI Doctor for Swallowing Problems?

By Amy Pittman, ExcelENT Speech-Language Pathologist

You are having trouble swallowing, and maybe you are also experiencing very bad acid reflux. What kind of doctor do you think you should see? For many, the answer is to make an appointment with a gastroenterologist who specializes in the upper gastrointestinal (GI) tract. While they may be able to help you in some instances, it may be that you also need the help of an ENT

It can be difficult to know which type of doctor best suits your needs, and sometimes you may even need both. In this article we will discuss the differences between the two most likely conditions you may have, which are laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD).

ENT vs. Upper GI — Where Is Your Problem?

First, let’s define what LPR and GERD are exactly.

Laryngopharyngeal reflux (LPR) is a condition in which stomach acid escapes out of the stomach and goes into the esophagus and throat. 

The acid irritates the throat, the vocal cords, and even the nasal passages. It may result in voice problems, swallowing problems, and sinus drainage. LPR is often referred to as “silent reflux” since many people with LPR do not experience heartburn. This is because the laryngeal area is much more sensitive to stomach acid than the esophagus.

The symptoms of LPR are felt primarily in the throat and may include the following:

  • Sore throat
  • Mild hoarseness
  • The sensation of a lump in the throat
  • The need to clear the throat
  • The sensation of mucus sticking in the throat, and/or post-nasal drip
  • Chronic (long-term) cough
  • Difficulty swallowing
  • Red, swollen, or irritated larynx (voice box).

Gastroesophageal reflux disease (GERD) occurs when stomach acid frequently flows back into the tube connecting your mouth and stomach (esophagus). This backwash (acid reflux) can irritate the lining of your esophagus.

Common signs and symptoms of GERD include:

  • A burning sensation in your chest (heartburn), usually after eating, which might be worse at night
  • Chest pain
  • Difficulty swallowing
  • Regurgitation of food or sour liquid
  • The sensation of a lump in your throat

So when acid repeatedly “refluxes” from the stomach into the esophagus alone, this is GERD. When stomach acid travels up the esophagus and spills into the throat or voice box, this is LPR. People with GERD tend to experience heartburn or a feeling of acid coming up. People with LPR are more likely to have a cough, throat clearing, hoarseness, or a feeling of something stuck in their throat. Of course, some people have both!

What To Do If You Experience LPR or GERD

You should start by examining your symptoms. If your swallowing problems include food feeling stuck in your throat or you are experiencing the regurgitation of food, you may want to start by seeing a GI. You can also come straight to ExcelENT of Alabama for an ENT evaluation. Since GERD and LPR often occur together, we do sometimes collaborate with a GI doctor. The GI will focus on the esophagus and stomach, while we will focus on the throat area.

When it comes to LPR, the most effective treatment is usually a combination of medication and lifestyle changes. Lifestyle changes might include things like avoiding eating right before bed and reducing the intake of problem foods. Acidic foods and drinks are problematic, as well as caffeine, alcohol, carbonated beverages, mint, and high-fat foods.

Discover how the team at ExcelENT of Alabama can help manage swallowing problems, such as LPR.

Don’t put off making an appointment with ExcelENT’s Speech-Language Pathologist Amy Pittman if you are experiencing swallowing problems. Together with Dr. Christopher Davis, Amy can diagnose your issue and develop a treatment plan in no time. Schedule an appointment online, or call to discuss coming in at a time that’s best for you: 205-988-6858.


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