Introduction

Have you ever wondered why, sometimes after a nice meal, a weird, burning sensation down your throat ruins the experience? You are not alone. That uncomfortable feeling may be a sign of acid reflux, which occurs when stomach acid escapes from the stomach and travels up into the oesophagus and throat. 

This is attributed to many factors, and food can be one of them. Certain foods can trigger these throat symptoms, without you even realising it’s related to your stomach and food choices.

Acid reflux and its correlation to throat symptoms

Digestion starts from the moment food enters the mouth. It then passes through the oesophagus and makes the first long stop at the stomach. At the bottom of the oesophagus, there is a small ring of muscle called the lower oesophageal sphincter (LES). The LES acts like a one-way valve; it opens up to allow food to enter the stomach and then closes to prevent food from coming back up.¹

Once food is in the stomach, hydrochloric acid (known as stomach acid) is released. Food starts dissolving with the help of the stomach acid and digestive enzymes.²

Stomach acid is strong, and while the stomach can handle it, the rest of the body cannot. When stomach acid is present in the oesophagus or throat, it can cause irritation and damage. Symptoms usually include sore throat, hoarseness, and heartburn. 

These symptoms can be triggered by certain foods and/or by a poor LES closure. 

How to diagnose acid reflux

A healthcare provider will get your medical history and note down your symptoms. If you experience acid reflux episodes more than twice a week, you may be tested for GERD (Gastroesophageal Reflux Disease). 

Tests to diagnose GERD include:

Upper Gastrointestinal (GI) Endoscopy

An endoscope with a camera attached to it is inserted through the mouth and provides visibility in your oesophagus, stomach, and duodenum. A biopsy sample may also be taken to study any suspected tissue.

Oesophageal pH Monitoring

This test uses a catheter or an endoscope to search for stomach acid in the oesophagus. Additionally, a monitor is worn by the patient, and it tracks information, with the help of the catheter or the endoscope, about the patient’s diet and symptoms in the esophagus.³

Foods that may trigger throat symptoms

Acidic foods

Examples: Citrus, berries, tomatoes, vinegar

Reason: Citrus foods have a naturally low pH, which can be harsh on the internal tissues and cause irritation. A low pH increases acidity, and therefore, it can affect the oesophagus and throat. It can also weaken the LES, which will increase the permeability of stomach acid to the oesophagus and then the throat, ultimately causing throat symptoms. 

Spicy foods

Examples: red chilli peppers, wasabi, hot sauces, raw garlic, and onion

Reason: Spicy foods increase stomach acid. In particular, capsaicin, the compound responsible for the spiciness of red chilli peppers, is associated with increased stomach acid secretion. An “excess” of stomach acid can weaken the LES, reach the throat, and cause symptoms like hoarseness, sore throat, or cough due to throat burning.

Fried foods

Examples: French fries, fried meat, doughnuts

Reason: Fried foods contain high levels of fat, which is slower to digest. The longer the food stays in the stomach, the more acid is produced to help digest it. The increased stomach acid that is created can reach the LES and irritate it. Eventually, food mixed with stomach acid can reach the oesophagus and throat, causing unpleasant throat symptoms.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, fat-rich foods can contribute to acid reflux symptoms.⁴

Caffeine and chocolate

Examples: coffee, mocha drinks, chocolate desserts

Reason: Both caffeine and chocolate can increase stomach acid production. Chocolate has theobromine, a compound known to weaken the LES. It is also high in fat, which can slow digestion and produce more stomach acid. 

When you already have a sore throat, both caffeine and chocolate can increase throat irritation and the feeling of heartburn, especially if you consume them on an empty stomach or late in the evening. 

Carbonated drinks and alcohol

Examples: soda, beer, sparkling water, wine, cocktails

Reason: Carbonated drinks can cause bloating, which puts extra pressure on the stomach. The pressure can cause stomach acid to rise to the throat, especially if the LES is weak. Alcohol can weaken the LES. During an episode, if acid is already present in the throat, carbonated drinks and alcohol can worsen irritation of the throat lining and cause heartburn symptoms.⁴

Why you might have throat symptoms without heartburn

While heartburn is a common side effect when stomach acid travels to the throat, not everyone experiences it. Many people experience throat discomfort without heartburn. Such cases are known as “silent reflux”, where individuals experience stomach acid reaching the throat and symptoms such as hoarseness, but not the typical chest discomfort and heartburn.⁵

Physiologically, stomach acid reaching the throat works the same way for everyone: acid escapes the stomach, travels up the oesophagus, and may reach the throat. However, each individual reacts differently, and symptoms vary from person to person.

Simple tips to reduce food-triggered throat symptoms

If you notice that certain foods or drinks irritate your throat and/or cause heartburn, there are some tips you can follow to relieve symptoms. To prevent or ease flare-ups, you can try to:

• Eat smaller meals with vegetables: Small, light meals are digested faster than large, fried/oily meals. This means that the stomach acid is present in the stomach for a shorter amount of time, reducing the possibility of an acid reflux episode. Meals rich in vegetables can increase your satiety, and when you stay full for longer, you are less likely to eat snacks. This way, you limit the acid production cycles, ultimately minimising throat irritation from possible episodes
• Avoid lying down after eating: Gravity plays an important role in digestion by helping food go through the mouth, to the oesophagus, to the stomach, and to the intestines. When you lie down after a meal, especially a big one, the change in gravity can move food in the wrong direction. In individuals where the LES is already weak, food mixed with stomach acid can travel back to the oesophagus and throat, causing heartburn, cough, and irritation. ⁶ If you experience acid reflux after meals, it is advisable to take a short walk to help speed up digestion instead of lying down
• Keep a food diary to track triggers: Tracking your symptoms, acid reflux episodes, and food triggers can help you identify patterns and improve your awareness of what affects your symptoms
• Try cutting back on specific food items or habits: If you identify triggering foods, cooking habits, or lifestyle choices that make your symptoms worse, you may try limiting certain foods and/or activities to see whether there is improvement in your symptoms

When to consult an expert 

Occasional and mild throat irritation caused by certain foods is normal; however, if symptoms become frequent, it is advisable to seek help from a healthcare professional. Suspicious symptoms include frequent heartburn that does not go away, difficulty swallowing, weight loss, and chronic cough or sore throat. 

Getting a proper diagnosis as soon as symptoms appear can help you manage them more effectively and may prevent the condition from worsening over time. Stomach acid is not supposed to be in the throat and oesophagus, and long-term exposure can lead to conditions like oesophagitis or Barrett’s oesophagus^.

A healthcare professional can give you a diagnosis and a structured action plan to limit acid reflux episodes, improve your symptoms, and avoid serious complications. 

Summary

Food is perceived as a pleasure for many, but the experience can be ruined when you deal with acid reflux and throat pain afterwards. Food-related throat symptoms from stomach acid are common and usually include hoarseness, cough, and heartburn. Acidic, spicy, and fried foods are usually responsible for causing such symptoms. Chocolate and alcohol are also known triggers that cause acid reflux episodes. All these food categories lead to one common complication: they weaken the LES. When the LES does not function properly, food mixed with stomach acid can pass through it and reach the throat. Lifestyle choices and eating habits such as lying down after a big meal, frequent snacking, and consuming large meals can further exacerbate symptoms, especially when the LES is already weak. 

Lifestyle modifications and diet adjustments, such as taking a walk after a meal, consuming meals with vegetables to increase satiety, avoiding frequent snacking, and limiting triggering foods, can show great improvement in symptoms over time. 

If symptoms do not seem to improve, it is advisable to consult a doctor or dietitian for potential tests that may be needed.