Cobblestone throat refers to the nodular appearance of the throat. It is caused by tissue swellings as a result of inflammation or irritation.
Larygopharyngeal reflux (LPR), on the other hand, describes the backflow of stomach content into the throat.
Both the above are terms more commonly used by our ear, nose & throat specialist treating patients with hoarse voice or throat discomfort.
A well-known cause of cobblestone throat is post-nasal drip. Excessive discharge from the nose flows backwards and irritates the throat mucosal surface. This is by far the most common cause of cobblestone throat.
LPR is believed to be a special form of "silent" gastric reflux reaching the throat without the classical symptoms of heart burn or regurgitation.
To draw an association between the two is often challenging and tedious. Beside endoscopic examinations of the throat and the oesophagus for clues consistent with gastric reflux, specific tests such as pH study of the upper oesophagus may be required. The real problem lies in the interpretation of these test results. Indeed, there is a lack of a sensitive enough test as well as a definitive set of criteria to confirm the diagnosis.
One common way out is a trial of acid suppression treatment to see if the throat symptoms or cobblestone throat improves. Patients can also use other treatment such as nasal spray or antihistamine medication if the root cause is believed to be a local sensitivity issue.
The presence of cobblestone appearance in the throat alone without other symptoms may not require any treatment.
- Dr Quan
