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Wednesday, January 18, 2017

Sore Throat and Acid Reflux: Causes and Treatment

I would also consider underlying obstructive sleep apnea as a predisposing factor for acid reflux. The mechanism appears to be through increased negative intrathoracic pressure. When a sleep apneic falls asleep, muscle tone is reduced and the upper airway (outside the chest) may partially or completely collapse (like a floppy garden hose). As the airway narrows/collapses, air entry to the lungs is reduced and oxygen levels in the blood may start to fall. The body responds by increasing the muscular effort of the chest and abdomen to draw more air past the airway obstruction into the chest. The analogy is if you're drinking a soft drink through a straw and I pinch your straw with my fingers, you have to suck harder to get the same amount of fluid up into your mouth. Likewise, the increased effort of the chest and abdomen creates a high negative pressure around the lungs in order to suck air into the chest. This pressure is transmitted to the esophagus (food pipe) which effectively turns it into a big straw sucking gastric contents up into the chest--esophageal reflux. By treating the obstructive sleep apnea, the intrathoracic pressure returns to normal and gastric contents remain below the diaphragm where it belongs--esophageal reflux symptoms typically improves/resolves.
from Rajesh Harrykissoon, MD

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