Acid reflux occurs when stomach contents, including stomach acid, flow back into the esophagus. This backflow can lead to a distressing sensation of choking. Understanding how to manage these episodes and prevent their recurrence can provide significant relief.
Immediate Steps During an Episode
When experiencing a choking sensation due to acid reflux, maintaining composure is important. Sitting upright can help gravity keep stomach contents down, easing the feeling of obstruction. Leaning forward slightly or standing can also help clear the airway.
Taking small sips of water, if safe to swallow, may help wash down any acid or food particles in the esophagus or throat. Avoiding lying down immediately after an episode is advisable. These immediate actions can help manage discomfort and prevent further aspiration.
Why Acid Reflux Causes Choking
Acid reflux causes choking when stomach acid irritates sensitive tissues in the throat and airway. The lower esophageal sphincter (LES), a muscular valve between the esophagus and stomach, normally prevents acid from flowing upward. When this sphincter relaxes or is weakened, acid can reflux into the esophagus and even reach the pharynx and larynx.
This acidic exposure can irritate the vocal cords and surrounding areas, triggering laryngospasm, where the vocal cords involuntarily close. This spasm can lead to a sudden inability to breathe, which is perceived as choking. In some instances, stomach contents can also be aspirated, or inhaled, into the lungs, causing coughing and respiratory distress.
Preventing Future Episodes
Preventing future acid reflux episodes involves lifestyle adjustments. Dietary changes are impactful, such as avoiding high-fat foods, acidic items like citrus and tomatoes, and trigger foods like chocolate, caffeine, and spicy dishes. Incorporate high-fiber foods like whole grains, root vegetables, leafy greens, and watery foods like celery and watermelon. Eating smaller, more frequent meals, rather than large ones, can also lessen pressure on the stomach and reduce reflux. Avoid eating close to bedtime, ideally allowing two to three hours before lying down.
Weight management plays a role, as excess weight can increase pressure on the stomach and contribute to reflux. Quitting smoking and reducing alcohol consumption are important steps, as these can weaken the esophageal sphincter and increase acid production. Elevating the head of the bed by six to eight inches during sleep, using risers or a wedge pillow, utilizes gravity to keep stomach contents in place and can significantly reduce nighttime reflux. Over-the-counter medications like antacids, H2 blockers, and proton pump inhibitors (PPIs) can also help manage symptoms by neutralizing or reducing stomach acid.
When to Seek Medical Help
While occasional acid reflux is common, certain symptoms warrant medical evaluation. If choking episodes are frequent or severe, or if you experience persistent difficulty swallowing (dysphagia), consult a healthcare professional. This difficulty might feel like food is getting stuck in the throat or chest. Other signs that indicate a need for medical attention include unexplained weight loss, persistent chest pain, or vomiting blood or black, tarry stools.
In emergency situations, such as complete airway obstruction, turning blue, or loss of consciousness, call emergency services immediately. Ignoring persistent or severe reflux symptoms can lead to complications such as esophagitis (inflammation of the esophagus), esophageal strictures (narrowing of the esophagus due to scar tissue), or Barrett’s esophagus, a precancerous condition. Prompt medical assessment can help identify underlying issues and establish an appropriate treatment plan.