Men's Health: Oversize tonsils linked with stomach acid reflux

A person's tonsil size may help doctors diagnose a condition in which acid escapes from the stomach and irritates the voice box.

This condition, called laryngopharyngeal reflux, occurs when the muscles that normally keep stomach acid from flowing back into the esophagus fail to work properly. If the acid travels high enough, it may cause a dry cough, chronic throat clearing and a sensation of something being stuck in the throat, without necessarily leading to heartburn.

The gold standard for diagnosing reflux is a "pH study," but it requires patients to wear a tube that goes through their nose and into their esophagus for 24 hours -- an uncomfortable and potentially expensive proposition, says Dr. Iman Naseri, a chief resident at Emory University in Atlanta. Instead, doctors often rely on symptoms and a physical examination, but these are less reliable, Naseri says.

In an effort to improve the latter approach, Naseri and his colleagues studied 19 patients whose reflux was confirmed by a pH study. They found that the larger the person's lingual tonsils, the worse the reflux. The lingual tonsils are a pair of bumpy pink or bluish areas toward the back of the tongue.

Naseri says the presence of enlarged lingual tonsils can therefore help doctors decide whether someone is suffering from laryngopharyngeal reflux.