From the Guidelines
For severe throat pain from stomach acid burning or vomiting, I recommend gargling with a solution of warm salt water (1/2 teaspoon of salt in 8 ounces of warm water) or a mixture of equal parts liquid antacid (such as Maalox or Mylanta) and water. Over-the-counter options include benzocaine-containing throat sprays like Chloraseptic (0.5-1.5% strength) or lozenges containing benzocaine or menthol, which can be used every 2-3 hours as needed. Prescription options may include viscous lidocaine 2% solution for gargling (5-10 mL every 3-4 hours, spit out after gargling) 1. These treatments work by either coating the irritated tissue, neutralizing acid, or temporarily numbing the area. While providing relief, it's essential to address the underlying cause of the acid reflux or vomiting, as suggested by the American Gastroenterological Association medical position statement on the management of gastroesophageal reflux disease 1. Stay upright for at least 30 minutes after eating, avoid eating within 3 hours of bedtime, and consider using acid-reducing medications like omeprazole or famotidine if reflux is ongoing, as recommended in the AGA clinical practice update on the personalized approach to the evaluation and management of GERD: expert review 2, 3, 4. If symptoms persist beyond a few days or are severe, medical evaluation is necessary to rule out other potential causes and to determine the best course of treatment.
Some key considerations for managing GERD symptoms include:
- Optimizing PPI therapy, including ensuring adequate timing of dose, considering escalation to double dose, and/or switching to a different PPI 2
- Using ambulatory reflux monitoring to diagnose and manage GERD symptoms 4
- Considering the use of H2 receptor antagonists (H2RAs) or other antacids for patients who do not respond to PPI therapy 2
- Evaluating the appropriateness and dosing of PPI therapy within 12 months after initiation, and offering endoscopy with prolonged wireless reflux monitoring off PPI therapy to establish appropriateness of long-term PPI therapy 3
From the FDA Drug Label
Purpose Oral anesthetic Active ingredient Benzocaine 20.0% (w/w) Benzocaine (TOP) could be considered as a topical gargling analgesic for a patient with severe throat pain from stomach acid burning/vomiting, as it is an oral anesthetic 5.
- The active ingredient is Benzocaine 20.0% (w/w) 6. It may help provide temporary pain relief.
From the Research
Topical Gargling Analgesics for Severe Throat Pain
- For patients with severe throat pain from stomach acid burning/vomiting, a topical gargling analgesic may be beneficial in providing relief.
- According to a study on lidocaine 8 mg sore throat lozenges 7, lidocaine was found to be superior to placebo in reducing pain intensity and providing pain relief for patients with acute pharyngitis.
- However, it is essential to note that the studies provided do not specifically address the use of topical gargling analgesics for severe throat pain caused by stomach acid burning/vomiting.
- The studies primarily focus on the treatment of acute pharyngitis, which may have different underlying causes and symptoms.
Treatment of Acute Pharyngitis
- The treatment of acute pharyngitis typically involves the use of antibiotics, such as penicillin or amoxicillin, for bacterial infections 8, 9.
- However, for viral infections, treatment is usually focused on relieving symptoms, such as pain and inflammation 10, 11.
- The use of corticosteroids may also be considered in some cases to reduce inflammation and relieve symptoms 11.
Considerations for Topical Gargling Analgesics
- When considering a topical gargling analgesic for severe throat pain, it is crucial to choose an option that is safe and effective.
- Lidocaine, as mentioned earlier, has been shown to be effective in reducing pain intensity and providing pain relief 7.
- However, it is essential to consult with a healthcare professional to determine the best course of treatment for individual cases of severe throat pain.