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Suggest Treatment For Pain In Throat
Question: I am suffering from a pain in my throat/larynx with an frequent need to clear my voice and I went already through different medical exams. I just want to be sure if I really can exclude the chance of reflux or silent reflux (LPR). I had a ph metry in the esophagus with a complete negative result. afterwards I still received a ph metry where the sensor is located in the throat (Restech Dx Ph measurement system). I had a few events of gaseous events, however I was inside the range (being in an upright position the score should be < 9,41 and I resulted 2,12, in an horizontal position the score should be <6,80 and I resulted 3,65), a Manometry showed a hypotension in the superior sphincter, it says week peristalsis in the esophagus.
I have to say that in the past I suffered from reflux (Gerd) and received a Nissan surgery (around 7 years ago). the Endoscopy which was now done resulted in no evidence for reflux and apparently the recreated valve looks still perfect - I am with an ENT specialist and I went through many medical exams and nothing could be found so far except two small thyroglossal cysts with macrophage content (size 8mm and 4mm) which my doctor would like to remove. thank you for your reference
I have to say that in the past I suffered from reflux (Gerd) and received a Nissan surgery (around 7 years ago). the Endoscopy which was now done resulted in no evidence for reflux and apparently the recreated valve looks still perfect - I am with an ENT specialist and I went through many medical exams and nothing could be found so far except two small thyroglossal cysts with macrophage content (size 8mm and 4mm) which my doctor would like to remove. thank you for your reference
Brief Answer:
Impedence testing might help
Detailed Answer:
Hello,
I have gone through your reports,
Your pH metry tests indicate that there is no acid reflex in the food pipe,
A normal pH metry does not rule out volume reflux. Was impedence testing also done along with the pH measurement and manometry measurement?
Sometimes non acid volume reflux can cause the symptoms you have described.
In case Impedence testing was not done getting it done will rule out significant reflux disease.
In case Impedence testing fails to show any cause then I would suggest Twice a day pantoprazole.
If the symptoms are troubling I would consider offering Tricyclics or SSRI drugs to deal with visceral hypersensitivity ( hypersensitive inner lining of the food pipe).
Please consult your doctor and discuss these options.
Hope this helps,
Do get back in case you have further queries.
Regards
Dr Samir Patil
Impedence testing might help
Detailed Answer:
Hello,
I have gone through your reports,
Your pH metry tests indicate that there is no acid reflex in the food pipe,
A normal pH metry does not rule out volume reflux. Was impedence testing also done along with the pH measurement and manometry measurement?
Sometimes non acid volume reflux can cause the symptoms you have described.
In case Impedence testing was not done getting it done will rule out significant reflux disease.
In case Impedence testing fails to show any cause then I would suggest Twice a day pantoprazole.
If the symptoms are troubling I would consider offering Tricyclics or SSRI drugs to deal with visceral hypersensitivity ( hypersensitive inner lining of the food pipe).
Please consult your doctor and discuss these options.
Hope this helps,
Do get back in case you have further queries.
Regards
Dr Samir Patil
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Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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