Reflux Symptoms & Pepsin
Now, let’s look at the difference between what happens in the esophagus when a reflux event takes place, compared to what happens in the larynx, or the bronchi, or the nasal passages. One of the predominant substances that causes the injury is known as pepsin, which is a normal digestive enzyme produced by your stomach. The difference is that once the pepsin enters the esophagus it cannot stick to the tissue because of the protective mucus layer. In contrast, the mucus layer in the larynx or the upper airway area is actually very thin. There the pepsin is absorbed directly into the tissue and it remains in the tissues resident without causing any damage. However, in the course of our day, we typically will eat or drink many acid type foods or beverages such as fruit juices or other fruits such as citrus, tomato based products, wine or vinegar just to name a few.
When the acid in our food or beverages comes in contact with the tissue that has the pepsin inside, the pepsin then activates, and that creates an inflammatory response. That inflammatory response can result in pain in your throat, increased mucus production, loss of voice strength or hoarseness, and even more serious conditions such as bronchitis, pneumonia, chronic nasal drip, pain into the ears, and, in some cases, sleep apnea.