From the Guidelines
For soothing throat pain in esophagitis, I recommend proton pump inhibitors such as omeprazole (0.7-3.3 mg/kg/d) or lansoprazole (0.7-3 mg/kg/d), which are effective for reducing acid production and allowing the esophagus to heal, as suggested by the most recent study 1. The study published in 2022 in Clinical Gastroenterology and Hepatology 1 provides the most up-to-date guidance on the management of GERD, including the use of PPIs for symptom relief and healing of erosive esophagitis. Some key points to consider when using PPIs include:
- Ensuring adequate timing of dose
- Considering escalation to double dose
- Switching to a different PPI if necessary
- Weaning down to the lowest effective dose once symptoms are controlled
- Exceptions to weaning acid suppression include patients with erosive esophagitis, biopsy-proven Barrett’s esophagus, and/or peptic stricture, who require long-term PPI therapy. In addition to PPIs, other options for soothing throat pain in esophagitis include:
- Liquid antacids like Gaviscon or Mylanta, which coat the esophagus and provide quick relief
- Sucralfate suspension (1 gram four times daily), which creates a protective barrier over inflamed tissue
- Over-the-counter throat lozenges containing benzocaine or menthol, which can temporarily numb the area
- Drinking warm (not hot) liquids like herbal tea with honey, which can provide natural soothing effects. It is also important to avoid spicy foods, alcohol, caffeine, and acidic beverages during treatment, as these can worsen symptoms 1.
From the FDA Drug Label
Omeprazole delayed-release capsules are used in adults: • for up to 8 weeks to heal acid-related damage to the lining of the esophagus (called erosive esophagitis or EE).
Omeprazole delayed-release capsules reduce the amount of acid in your stomach.
For children 2 to 16 years of age, omeprazole delayed-release capsules are used: • for up to 8 weeks to treat gastroesophageal reflux disease (GERD) with acid-related damage to the lining of the esophagus [called erosive esophagitis (or EE) due to acid-mediated GERD]
Omeprazole is a medication that can help soothe throat pain in esophagitis by reducing the amount of acid in the stomach. It is used to treat erosive esophagitis and gastroesophageal reflux disease (GERD), which can cause throat pain. The typical treatment duration is up to 8 weeks. However, it is essential to follow the prescribed dosage and treatment regimen as directed by a doctor. 2 2
From the Research
Medications for Throat Pain in Esophagitis
- Proton pump inhibitors (PPIs) such as omeprazole and lansoprazole have been shown to be effective in healing and maintaining erosive or worse esophagitis 3.
- PPIs have been found to be superior to H2 receptor antagonists in treating refractory reflux esophagitis, with a significant reduction in intraesophageal acidity 4.
- A study comparing the efficacy of PPIs and H2RAs in healing reflux esophagitis found that PPIs had a higher healing rate, especially in patients with lower-grade esophagitis 5.
- A cost-effectiveness analysis found that PPIs were more effective than H2RAs in preventing recurrences of erosive reflux esophagitis, although they were also more costly 6.
- PPIs have also been found to be effective in inducing and maintaining remission in eosinophilic esophagitis, with a clinical response rate of 65% and a histological remission rate of 45.4% 7.
Specific Medications
- Omeprazole: 20 mg once daily 3, 4, 5
- Lansoprazole: 30 mg once daily 3
- Pantoprazole: not specified in the provided studies, but mentioned as a third PPI option 3
- Famotidine: 20 mg twice daily 4, 5
Dosage and Administration
- The dosage and administration of PPIs may vary depending on the specific medication and the patient's condition.
- Double doses of PPIs have been found to be more effective than standard doses in achieving histological remission 7.
- Maintenance half doses of PPIs have been found to be effective in sustaining histological remission 7.