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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What is the treatment for mouth ulcers?

I have had mouth ulcers at the back of my throat on and off for a year now. I have a possible diagnoses of silent reflux but the ulcers have tiny black dots in them. I am short of breath and on a really rare occasion need to cough. I have no check pain. Is this the right diagnoses and if it is why is treatment not working?
Thu, 18 Sep 2014
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ENT Specialist 's  Response
Hi. Mouth ulcers can occur in the throat for a variety of reasons. The most common being due to Vitamin B12 deficiency which may be precipitated by silent reflux or LPRD (Laryngopharyngeal Reflux Disease) and the other common reason being infection.

A good oral rinse and gargle with an antiseptic solution three times daily before and after meals along with multivitamin supplementation once a day should take care of the ulcer.

In LPRD small amounts of acid from the stomach create injury and inflammation around the voice box leading to swelling in the interarytenoid region (posterior portion of the voice box). This is what causes the sticking feeling in the throat and the acid irritation leads to the occasional dry cough. LPRD is different from GERD or Gastroesophageal Reflux Disease and therefore may not be associated with symptoms of gastritis such as burning chest pain, stomach pain and gas.

Management of this condition involves keeping the LPRD under control and allowing the voice box to heal (2-3 weeks). This is a challenge because there is more effort required from the patients in the form of lifestyle changes and little support provided by medications. Antacids and lifestyle changes may need to be followed for 6 months or more for complete cure.

Here are some recommended lifestyle modifications

1. Reduction of spicy and fried food/tea/ coffee/ carbonated drinks
2. Reduction of smoking and alcohol consumption
3. To maintain an upright posture for up to 2 hrs after meals. Avoid lying down immediately after meals.
4. Raise the head end of your bed. Avoid raising the height of the pillow.
5. Voice rest for 48 hrs

Let me know if I can help answer any other questions.
Hoping for a speedy recovery
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