When you've taken stomach medicine for years but still feel something stuck in your throat

What follows combines several people's visits into one reconstructed account. It is not any one person's story, and anything that could identify someone has been removed.

How do people describe it when they come in?

They've taken stomach medicine for a long time, and the heartburn has eased — but the feeling of something stuck in the throat and a dry cough are still there.

Many also mention a feeling of something constantly running down the back of the throat. Coughing up phlegm doesn't clear it, and breathing in cold air makes it worse.

They don't come in just to talk about the stomach. They also say their voice isn't what it used to be, and talking for a long time is tiring.

Why is the throat still the same even with medicine?

Medicines that suppress stomach acid reduce the irritation acid causes when it comes back up into the esophagus. Their advantage is that the burning settles quickly. But why it overflowed in the first place stays the same.

We see the starting point in the blood flow to the stomach. If not enough blood reaches it, stomach acid gets weaker, and weak acid can't digest food in time. Then the body tries to make up the shortfall with volume. That extra stomach fluid eventually overflows upward.

If, on top of that, the stomach can't physically move well, food stays put instead of moving down, and the irritation in the throat keeps going.

What do we look at?

We press on your abdomen, checking separately how hard the area below the breastbone and under the ribs is, and whether the lower belly has strength.

We also watch how far the chest and abdomen move when you breathe in. In people who have been tense for a long time, this movement is small. A stiff neck, shoulders and front of the chest usually come along with it.

We always check your medications. If you've taken them for a long time, we ask how long, and what happened when you stopped.

How do we treat it?

We don't tell you to stop the medication you've been taking. We first build up the stomach's ability to move on its own; cutting back is decided later, in consultation with your prescribing doctor.

There's an order. First we warm a stomach that has gone cold and get its movement going again. We use herbal medicine, pharmacopuncture, and visceral Chuna, in which we work on the abdomen directly by hand.

Next comes the throat. We loosen the stiff neck and front of the chest so you can breathe deeply. If we work on the throat first, things keep coming up from below, so we stick to this order.

How did people do?

What usually changes first is the bloating after meals. The feeling of something stuck in the throat tends to fade later, so we tell you this order in advance.

If you come in expecting the throat to improve first, it's easy to feel "nothing's getting better." So we explain at the start what changes first.

If we don't find a direction after a few visits, we recommend other tests.

What are the limits of this approach?

The feeling of something stuck in the throat has other causes too, such as thyroid problems or problems with the larynx and vocal cords. What we look at is just one of those paths.

If your voice stays hoarse for a long time, swallowing gets harder and harder, or you're losing weight without trying, see an ENT doctor and a gastroenterologist for tests first.

If you have the same symptoms

1. Sometimes the heartburn eases but the throat stays the same.
2. Suppressing acid and finding out why it overflows are two different jobs.
3. We start by pressing on the abdomen to see how well the stomach moves.
4. We won't tell you to stop your medication — that's decided with your prescribing doctor.
5. If your voice stays hoarse or swallowing is hard, get tested for that first.

We don't look only at your stomach. Sometimes it only gets better when we also look at sleep, the neck and posture.

If you've taken medication for a long time and nothing has changed, come and see us. We don't look only at your stomach. Sometimes it only gets better when we also look at sleep, the neck and posture.

Because there are many possible causes, progress differs from person to person, even with the same care.