Laryngitis gastrica is a laryngitis caused by reflux of gastric acid. As a rule, the disease therefore appears as a symptom of reflux disease. For treatment, dietary measures and drug proton pump inhibitors are used.

What is a gastric laryngitis?

The main symptom of laryngitis gastrica are voice disorders. Hoarseness is one of the most important changes, but also impure, occupied or even toneless vocal sound can adjust.
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Laryngitis is an inflammation in the mucous membranes of the larynx. This inflammation can be either acute or chronic. Both children and adults can get sick. As a rule, laryngitis is either bacterial or viral. In the special form of laryngitis gastrica, however, neither bacteria nor viruses are the cause of the inflammation. Also chemical stimuli or vocal load are not responsible for the inflamed mucous membranes on the larynx in the laryngitis gastrica. Instead, the larynx in this disease is attacked by refluxing gastric juice.

This phenomenon is a symptom of reflux disease, so that gastric laryngitis usually occurs as a concomitant symptom of this disease. Reflux disease is a relatively common condition due to dietary habits in a well-to-do society. About 20 percent of Americans are affected by reflux down the throat. Almost half of them already had gastric laryngitis.

causes

There are sphincter muscles in the esophagus which prevent the gastric contents from rising again into the pharynx by the so-called resting pressure. Only when swallowing is the lower sphincter of the esophagus relaxed. If this sphincter is damaged, it creates a reflux. In addition, if the peristalsis is disturbed, there is an excessively long contact between the mucous membranes and stomach acid. This can cause inflammation in the larynx.

The causes can be of various kinds. For example, the eating and drinking habits of patients play a role. Spicy foods, fatty foods and coffee are considered risk factors for reflux disease. Likewise, a diaphragmatic fracture may result in relaxation of the esophageal sphincter and in disorders of esophageal peristalsis. Also diseases with excessive gastric acid formation come into question as cause, so for example the Zollinger Ellison syndrome. Also conceivable causes are general muscle weakness, medication or stress.

Symptoms, complaints & signs

The main symptom of laryngitis gastrica are voice disorders. Hoarseness is one of the most important changes, but also impure, occupied or even toneless vocal sound can adjust. As a rule, laryngitis causes pain. This pain ranges from a generally sore throat sensation to unbearable scratching. There is usually persistent urge to cough, with patients mainly reporting a dry cough.

Sometimes there is also a fever. In extreme cases, the mucous membrane of the larynx swells strongly, presses on the trachea and causes respiratory distress. In the mouth spreads a bitter taste due to the stomach acid and heartburn arises. In addition, some patients complain of a globus feeling that manifests itself during eating and drinking in dysphagia.

These dysphagia do not necessarily have to be present, but can also be attributed to the subjective feelings of those affected. Especially at night, the reflux symptoms set.

Diagnosis & disease course

In order to diagnose laryngitis gastrica, in addition to endoscopy and gastroscopy, a 24-h pH-metry is usually performed. The probes used for this purpose have a measuring point in the hypopharynx, which detects the reflux in the affected region. In a lupen laryngoscopic picture, this type of laryngeal inflammation manifests in hyperplasia of the posterior laryngeal mucous membranes.

The staining of the inflamed areas is relatively bright and the structure is crinkled. The gastric juice reduces the resistance of the mucosal barrier. Pollutants are thus easier to penetrate into deep cell layers. Also, changes in the mucosal immune system occur after some time. Chronic laryngitis gastrica may therefore favor, for example, laryngeal cancer.

complications

Due to the gastric laryngitis sufferers suffer primarily from hoarseness. This is not associated with a flu or a cold and usually remains permanent. Furthermore, the voice of the patient may change, which often suffer from pain. This pain can also spread to other regions of the body.

A cough also usually occurs and continues to reduce the quality of life of the person affected. Due to the inflammation, patients continue to suffer from fever and, in the worst case, shortness of breath. Not infrequently, the respiratory distress can lead to a loss of consciousness, in which the affected can hurt themselves. As a rule, gastric laryngitis also causes heartburn and also swallowing.

An ordinary intake of liquids and food is no longer possible for the person concerned, so that in many cases deficiency symptoms or malnutrition occur. The laryngitis gastrica can be treated with the help of medication. In general, however, a treatment of the underlying disease is necessary so that the symptoms do not occur again. There are usually no complications during treatment. However, patients also rely on a strict diet.

When should you go to the doctor?

In case of suspected laryngitis, a doctor should always be consulted. Anyone who suddenly notices a hoarseness or pain in the pharynx, confers at best directly with the family doctor. If laryngitis gastrica is treated early, the symptoms usually resolve quickly. At the latest, when fever is added to the voice disorders and pain, medical advice must be obtained. Severe heartburn, shortness of breath and difficulty in swallowing are further warning signs to be clarified.

People who eat unhealthy foods or have a condition that causes excessive stomach acidity are at particular risk. If the complaints in connection with the intake of medication, the best informed the appropriate physician. If stress is suspected as a cause, then a therapist should also be consulted. Other focal points for people with laryngitis gastrica are the gastroenterologist or an ear, nose and throat doctor. In case of hoarseness and pain when swallowing, children should first be introduced to the pediatrician. A laryngitis must be carefully monitored during recovery.

Treatment & Therapy

The treatment of laryngitis gastrica depends on the causes and the severity of the findings. A change in diet may make sense. Even abstaining from nicotine may be worthwhile, since nicotine stimulates gastric juice production. In addition, patients are often advised to take several small meals throughout the day. Hard-to-digest meals just before bedtime are deleted from the diet.

Overweight patients are also advised to reduce their overweight. If voice disorders are present, voice therapy is also recommended after an improvement of the mucosal image. As a drug treatment is considered a therapy with proton pump inhibitors as a treatment of choice. These drugs are said to inhibit the production of stomach acid. Often the drug administration is carried out on a trial basis and without further diagnostics on the basis of the anamnesis. However, this procedure is now heavily criticized.

For alarm signals, for example, no drug therapy should take place. The most important alarm signals include anemia and proliferation in the esophagus. In rare cases, laryngitis gastrica surgery is suggested as the primary route of treatment. This procedure is also known as fundoplication and corresponds to a minimally invasive procedure for restoring the closing function in the esophagus.

Outlook & Forecast

Normally, the inflammation of the larynx has a favorable prognosis. The disease is treated with medication. Under optimal conditions, the symptoms will be resolved within a few weeks. Especially in the case of acute laryngitis gastrica, medical care should be sought in order to improve health as quickly as possible.

In addition, it can lead to a chronic disease course. This is usually the case if the person concerned is also overweight or if there are any disturbances during the meal. In these cases, therapies should be used that work towards a specific improvement in lifestyle habits. There is a clarification on the cause of the discomfort and in addition, training is carried out, which the affected person can implement independently outside the therapy time. The prognosis is also favorable in the case of these disease progression, since the co-operation of the patient allows a freedom of complaint to be achieved.

If growths in the esophagus are noticed, surgical intervention is necessary to improve general health. The tissue changes must be removed to ensure that the patient is free of any complaints. The surgery involves risks and side effects. Nevertheless, in a large number of cases it is a routine procedure that proceeds without further complications. In most cases, the patient is released from treatment after recovering from wound healing.

prevention

The laryngitis gastrica can be prevented by a proper diet and the renunciation of alcohol and nicotine. The reduction of overweight can also be interpreted as a precautionary measure.

aftercare

Since gastric gastric laryngeal reflux causes gastric reflux in the larynx, care should be taken to ensure that it is prevented in the best possible way. This requires a change in diet by the patient and thus its active participation.

The portions of the meals should be smaller in this context. It is better to eat small meals a day rather than small ones, is the motto that also serves the digestive tract. In addition, sour, sweet and spicy foods have a tendency to stimulate gastric acid production and are therefore also to be reduced.

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

Sleeping is also of special importance for the reflux in laryngitis gastrica. In order to avoid a backflow of gastric acid into the sensitive areas of the larynx and throat, an increased sleeping position of the upper body is recommended. In addition, luscious meals before bedtime are unfavorable and should therefore be avoided. Stress can also promote reflux and must be consistently reduced.

You can do that yourself

If a gastric laryngitis has been diagnosed, the patient should primarily change his diet. It is recommended that you take several small meals and eliminate difficult to digest food from the diet. Regular hydration is also important to keep the mucous membranes moisturized and the virus flushed out quickly. In addition, must be dispensed with stimulants such as nicotine, alcohol and caffeine, as these irritate the stomach and throat and stimulate gastric juice production. Obese people have to reduce their weight in the long term.

Basically, in a laryngitis the voice should be spared. 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 natural remedies. Also helpful is inhalation with saline solutions and remedies such as sage or marshmallow. A room humidifier regulates the air and thus supports the recovery process.

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

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