GERD -Can Nodule Cause It or Was It Med

[kitcurious]

Dear Dr. Kini,

Thank you for taking my question. One year ago I went to the doctor with a feeling of something stuck in the right side of my throat. Internist sent me to GI doctor, though I had no heartburn, who did several tests including upper endoscopy. Everything looked normal and biopsy of tissue was normal. This did not surprise me.
In April a nodule (1.4 cm at that time right lower lobe) was found in my thyroid and my TSH was slightly elevated.  I was started ion T4 replacement therapy. 6 weeks later I was mildly hyperthyroid, they reduced dose but I then went very hyperthyroid and have been taken off med for months. Off the meds I am still hyperthyroid.
Within a few weeks of starting the levothyroxine med, I started hypersalivating and have been doing so for months.
Now I have heartburn for the first time in my life, still have a feeling of something stuck in my throat and have  tried Prilosec but still am hypersalivating, having heartburn and now am becoming nauseated.
Recent trip to ENT . ENT said he saw evidence of reflux.

Can a nodule in the throat cause reflux and will an obstruction effect the efficacy of medications like proton pump inhibitors?

Thank you

[Ratnakar Kini]

Hi kitcurious,

You have two problems -

1.Initially hypothyroidism and now hyperthyroidism
2. GERD

The symptoms of GERD include -
1. Heart burn
2. Swallowing difficulty and painful swallowing
3. Chest discomfort
4. Increased salivation
5. Burping, hiccups, nausea and vomiting

Other less common symptoms include -
1. Chest pain
2. Asthma
3. Sore throat, hoarseness of voice, stickiness in the throat, cough

Your nodule in the throat is not related in any way to your reflux. And also it wont interfere with the action of  PPI.

So you can continue PPI as suggested by your physician. If your symptoms do not improve report to him again and he may do a few other tests like pH monitoring.
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The information provided is for patients’ education only and is not a medical advice. Always consult your personal physician for complete evaluation of your health problem.

- Ratnakar Kini M.D.

[kitcurious]

Thank you !  

[Ratnakar Kini]

Hi,
The thyroid gland is situated outside and is well away from your food pipe.

So continue PPI and also meet your endocrinologist for your thyroid problem.

[kitcurious]

Also, unsucessful biopsy was done ( by endocrinologist) on nodule in November. Doc did not get enought material for evaluation. It does feel bigger than it did last year, but I have no report to tell you if the size of the nodule in my throat is, in fact larger.