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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 35796
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I've had a problem with my throat and ears for years. Every

Customer Question

Hello. I've had a problem with my throat and ears for years. Every morning when i wake up the very back of my throat is literally gooed shut. I cough and gag and hack up slim from the back of my throat. I usually get hacking so bad it kicks in my vomit reflex. If such a thing exists. Anyway i get nauseated. After several minutes of this embarrassing routine my throat clears and i feel better. I dont drink or smoke or really have any bad habits so whats wrong with my throat? A viral or bacterial infection? I had this for years and have mentioned it many times to my Dr.
JA: How long have you been dealing with the cough? Are you having any other symptoms?
Customer: I dont have a cough or a sore throat.
JA: Anything else in your medical history you think the doctor should know?
Customer: My ears always feel pressured up which increases as i bend over.
Submitted: 2 months ago.
Category: Medical
Expert:  Dr. Arun Phophalia replied 2 months ago.

Hello! My name is***** to JustAnswer. I'm reviewing your question now, and will post back with the reply momentarily.

Expert:  Dr. Arun Phophalia replied 2 months ago.

Your symptoms are suggestive of;

1) Acid reflux

2) Hiatal hernia.

An upper GI endoscopy and esophageal manometry is likely to diagnose it.

Following measures would help you:

1) antacids; Maalox

2) acid blocker; Prilosec

3) loosing weight, if overweight.

4) avoiding alcohol, citrus fruits and juices, chocolate, and tomato based products

5) avoiding large meals. Eat 5 small meals in a day.

6) wait three hours after the meal before you sleep.

7) elevate head end of the bed by 8 inches.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Customer: replied 2 months ago.
I take Pantoloc for acid reflux. Since i started on the pantoloc my acid reflux or heart burn and other symptoms have all vanished. But this throat goo persists
Expert:  Dr. Arun Phophalia replied 2 months ago.

Reflux laryngitis or laryngopharyngeal reflux or extraesophageal GERD, differs from traditional GERD in that it does not manifest as heartburn. This silent GERD can be present in as many as 80% of patients. The investigations to confirm it are;

1) Ambulatory 24-hour pharyngoesophageal pH monitoring
2) Barium esophagography
3) Laryngoscopy
4) Upper gastrointestinal endoscopy.

The other possibilities of the diagnosis are;

a) Chronic sinusitis; MRI of sinuses is advised.

b) Zenker diverticulum; barium swallow can diagnose it.

c) Post nasal drip.

It is privilege assisting you.

Customer: replied 2 months ago.
I never seem to experience nasal or sinus problems. I somehow seem to think this is related to my ear issues.
Customer: replied 2 months ago.
I dont wish to phone you as i have a family Dr and also can afford any further medical advice,
Expert:  Dr. Arun Phophalia replied 2 months ago.

Apologies for any intrusion of those automatic offers for phone calls. These are produced by the website automatically and outside of my control.

Customer: replied 2 months ago.
Cant afford
Expert:  Dr. Arun Phophalia replied 2 months ago.

The nerves of ear, sinuses and upper pharynx (behind the nose) have common nerve supply. So symptoms overlap.

Ear issues are very rare to cause these symptoms.

I am sure your primary care physician can be able to rule out ear issues and its association with these symptoms and refer you to an ENT specialist.

Customer: replied 2 months ago.
Ok thank you for your time. Oh one other thing. I have such a over active gag relex i now have trouble even brushing my teeth without gagging. I gargle for 10 minutes every night before i go to bed with Listerine but it dont really help.
Expert:  Dr. Arun Phophalia replied 2 months ago.

You are very welcome.

Some people can have sensitive soft plate which may cause gag reflex easily. Unfortunately there is not much treatment for it.

You may also try these to decrease your early morning symptoms:

1) Nasal saline drop; decrease inflammation and open up obstruction.

2) Oral decongestants such as pseudoephedrine are often helpful.

3) Topical decongestant for short duration.

4) Antihistamines; use only if known allergies.

5) Steam vaporizer

6) Eucalyptus oil may help

7) Vitamin C

It is privilege assisting you.

Expert:  Dr. Arun Phophalia replied 2 months ago.

Was this information helpful to you? I would be glad to answer any further questions.

It is privilege assisting you.

Please let me know if you have further queries or unanswered questions.
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Wishing you all the very best in life.