Gastric laryngitis

In the Gastric laryngitis is a laryngitis caused by acid reflux in the stomach. As a rule, therefore, the disease occurs as a symptom of reflux disease. Dietary measures and medicinal proton pump inhibitors are used for treatment.

What is gastric laryngitis?

The main symptom of gastric laryngitis is voice disturbance. Hoarseness is one of the most important changes, but impure, covered or even toneless voices can also occur.
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Laryngitis is inflammation in the lining of the larynx. This inflammation can be acute or chronic. Both children and adults can get it. Typically, laryngitis is either bacterial or viral. With the special form of Gastric laryngitis but neither bacteria nor viruses are the cause of the inflammation. Chemical stimuli or voice strain are also not responsible for the inflamed mucous membranes on the larynx in gastric larygitis. Instead, in this disease, the larynx is attacked by refluxing gastric juice.

This phenomenon is a symptom of reflux disease, so that gastric laryngitis usually occurs as an accompanying symptom in this disease. Reflux disease is a relatively common disease because of dietary habits in an affluent society. About 20 percent of Americans have reflux down to the throat. Almost half of them already had gastric laryngitis.

causes

In the esophagus there are sphincter muscles that prevent the stomach contents from ascending back into the pharynx by the so-called resting pressure. The lower esophageal sphincter is relaxed only when swallowing. When this sphincter is damaged, reflux occurs. If, in addition, the peristalsis is disturbed, there is excessively long contact between the mucous membranes and gastric acid. This can cause inflammation in the area of ​​the larynx.

The causes for this can be of various kinds. The eating and drinking habits of the patients play a role, for example. Spicy foods, fatty foods, and coffee are all assessed as risk factors for reflux disease. A diaphragmatic hernia can also lead to a relaxation of the esophageal sphincter muscle and disorders of the esophageal peristalsis. Diseases with excessive gastric acid build-up can also be a possible cause, for example Zollinger-Ellison syndrome. Other possible causes are general muscle weakness, medication or stress.

Symptoms, ailments & signs

The main symptom of gastric laryngitis is voice disturbance. Hoarseness is one of the most important changes, but impure, covered or even toneless voices can also occur. As a rule, laryngitis causes pain. These pains range from a general sore throat to an excruciating scratchy feeling. There is usually a permanent urge to cough, with patients reporting mainly a dry cough.

Sometimes there is also a fever. In extreme cases, the lining of the larynx swells, presses on the windpipe and causes shortness of breath. A bitter taste spreads in the mouth due to stomach acid and heartburn develops. Some patients also complain of a globus feeling, which manifests itself in swallowing difficulties while eating and drinking.

These swallowing disorders do not have to actually be present, but can also be due to the subjective feelings of those affected. The symptoms of reflux appear particularly at night.

Diagnosis & course of disease

To make the diagnosis of gastric laryngitis, in addition to an endoscopy and gastroscopy, a 24-hour pH-metry is usually performed. The probes used for this have a measuring point in the hypopharynx that records the reflux in the affected region. In a magnifying glass laryngoscopic image, this type of laryngitis manifests itself in hyperplasia of the posterior laryngeal mucous membranes.

The coloring of the inflamed areas is relatively light and the structure is wrinkled. The gastric juice reduces the resistance of the mucosal barrier. This makes it easier for pollutants to penetrate deeper cell layers. Changes in the mucous membrane immune system also appear after a long time. Chronic gastric laryngitis can therefore promote cancer of the larynx, for example.

Complications

Because of gastric laryngitis, those affected primarily suffer from hoarseness. This is not associated with the flu or a cold and usually remains permanent. The voice of the patient can also change, and it is not uncommon for them to suffer from pain. This pain can spread to other parts of the body.

A cough also usually occurs and continues to reduce the person's quality of life. Because of the inflammation, patients continue to suffer from fever and, in the worst case, from shortness of breath. Not infrequently, the shortness of breath can lead to a loss of consciousness, which can also injure those affected. As a rule, gastric laryngitis also leads to heartburn and also to difficulty swallowing.

Ordinary ingestion of liquids and food is no longer possible for the person concerned, so that in many cases there are deficiency symptoms or malnutrition. Gastric laryngitis can be treated with medication. As a rule, however, treatment of the underlying disease is also necessary so that the symptoms do not recur. There are usually no complications with the treatment. However, the patients are also dependent on a strict diet.

When should you go to the doctor?

If you suspect a larynx infection, you should always consult a doctor. If you suddenly notice a hoarseness or pain in the throat, the best thing to do is to confer directly with your family doctor. If gastric laryngitis is treated early, the symptoms usually subside quickly. Medical advice must be obtained at the latest when fever is added to the voice disorders and pain. Severe heartburn, shortness of breath and difficulty swallowing are further warning signs that need to be clarified.

People who eat unhealthily or suffer from a condition that causes excessive stomach acid are particularly at risk. If the complaints arise in connection with the use of medication, it is best to inform the doctor responsible. If stress is suspected to be the cause, a therapist should also be sought. Other contact points for people with gastric laryngitis are the gastroenterologist or an ear, nose and throat specialist. Children should first see a pediatrician if they experience hoarseness or pain when swallowing. Laryngitis must be carefully monitored during recovery.

Treatment & Therapy

Treatment of gastric laryngitis depends on the cause and severity of the finding. A change in diet can sometimes make sense. Avoiding nicotine can also be worthwhile, as nicotine stimulates gastric juice production. That being said, patients are often advised to eat several small meals throughout the day. Meals that are difficult to digest shortly before bed are removed from the menu.

Overweight patients are also recommended to reduce their excess weight. If there are voice disorders, voice therapy is also recommended after the mucous membrane has improved. As a drug treatment, proton pump inhibitor therapy is considered the treatment of choice. These drugs are designed to reduce the build-up of stomach acid. The medication is often administered on a trial basis and without further diagnostics based on the anamnesis. However, this approach is now heavily criticized.

In the event of alarm signals, for example, no drug therapy should take place. The main alarm signals include anemia and growths in the esophagus. Surgical intervention is suggested as the primary treatment option for gastric laryngitis only in rare cases. This procedure is also known as fundoplication and is a minimally invasive procedure to restore the closing function in the esophagus.

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Outlook & forecast

In normal cases, inflammation of the larynx has a favorable prognosis. The disease is treated with medication. Under optimal conditions, you will be free of symptoms within a few weeks. Medical care should be sought, particularly in the case of acute gastric laryngitis, so that health can be improved as quickly as possible.

In addition, it can lead to a chronic course of the disease. This is usually the case if the person concerned is also overweight or there are disturbances in eating. In these cases, therapies should be used that work towards a targeted improvement in lifestyle habits. There is an explanation of the cause of the complaints and training sessions are carried out that the affected person can implement independently outside of the therapy time. The prognosis is also favorable for these disease progressions, since the patient's cooperation can help to avoid symptoms.

If growths are noticed in the esophagus, surgery is necessary to improve general health. The tissue changes must be removed so that symptoms are free. The operation has risks and side effects. Nevertheless, in a large number of cases it is a routine procedure that proceeds without further complications. After the wound has healed, the patient is usually discharged from treatment as recovered.

prevention

Gastric laryngitis can be prevented by eating an adequate diet and avoiding alcohol and nicotine. The reduction of obesity can also be interpreted as a preventive measure.

Aftercare

Since gastric layryngitis is caused by the reflux of gastric acid into the larynx area, it is important to ensure that this is prevented in the best possible way during follow-up care. This requires a change in diet by the patient and thus his active cooperation.

In this context, the portions with meals should be smaller. It is better to eat small meals more often during the day than little large ones, is the motto that also serves the digestive tract. In addition, sour, sweet and spicy foods tend to stimulate gastric acid production and should therefore also be reduced.

Alcohol and nicotine can also promote reflux and should be significantly reduced or avoided altogether in the sense of a targeted reduction in acid production. In addition, nicotine for the stressed larynx area should be avoided in the aftercare of gastric laryngitis anyway. The regeneration can thus be significantly optimized.

In reflux, the sleeping posture is also of particular importance in gastric laryngitis. In order to prevent stomach acid from flowing back into the sensitive areas of the larynx and throat, an elevated sleeping position of the upper body is recommended. In addition, lavish meals before going to bed are unfavorable and should therefore be avoided. Stress can also promote reflux and should be consistently reduced.

You can do that yourself

If gastric laryngitis has been diagnosed, the patient should primarily change their diet. It is recommended that you eat several small meals and eliminate hard-to-digest foods from your diet. Regular hydration is just as important so that the mucous membranes are always well moistened and the viruses can be flushed out quickly. In addition, stimulants such as nicotine, alcohol and caffeine must be avoided, as these further irritate the stomach and throat and stimulate gastric juice production. Overweight people need to reduce their weight in the long term.

In principle, the voice should be spared in the case of laryngitis. Warm drinks relieve the pain and promote blood circulation. Neck wraps have a similar effect and can be combined with eucalyptus ointment, essential oils and other means from nature. Inhaling saline solutions and remedies such as sage or marshmallow is also helpful. A room humidifier regulates the air and thus supports the recovery process.

After the acute phase of illness, the immune system must be strengthened, be it through exercise in the fresh air, a diet rich in vitamins or lots of sleep and bed rest. If the symptoms of gastric laryngitis do not subside, an ENT specialist should be consulted.