Heartburn vs sour taste

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DOGGBONES
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   Posted 5/31/2013 5:34 AM (GMT -6)   
Heartburn is acid reflux, we all know that.....sour taste, however is bile? Any thoughts?

drtinsac
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   Posted 5/31/2013 10:04 AM (GMT -6)   
Here are some random thoughts..

I think it matters if the taste is constant vs. rare/intermittent. This is based on the assumption that bile is not going to reflux all by itself, it is the gastric juice that refluxes which contains bile. But it will also contain acid, pepsin and other stuff I'm unaware of. So if the taste is constant, and if the person is tasting the reflux itself, that means your entire esophagus and throat is subject to acid reflux constantly.. which means you would probably have horrible throat pain, be unable to speak, teeth rotting, the whole nine yards. True, the reflux becomes less acidic as it travels proximally since it's being buffered by saliva which has pH around 7.

If the taste is intermittent, it could be the way someone's body responds to reflux. This could be established using 24 hour ph/impedance study. In my case, it was very highly related to weakly acidic reflux during the ph study, however, my taste is constant and not intermittent. I had ~55 weakly acidic refluxes if I remember right, but that is not enough refluxes to have 24 hour sour taste.

I've not seen it written anywhere, but I think the sour taste could be the body's strategy to try to encourage swallowing in response to reflux, i.e. by generating a foul tasting substance in the mouth. A throat tightening (globus) sensation I think can also be a response the body uses to encourage swallowing. Swallowing saliva, or even dry swallow, can help to push down whatever the body feels to be refluxing.

There are several papers by Ronnie Fass MD, dealing with refractory GERD, where he recommends tricyclic treatment for people who have a sour taste -- they are termed hypersensitive esophagus. However as far as I have seen, he has given no explanation for this in these papers. It is unfortunate that there is lack of clarity with respect to various sour tastes, or even what "sour" means. I have had acid taste in my mouth, which burned my throat, and I could classify as "sour". But I also have a constant taste which classifies as "sour". So in both cases, I could describe it as a sour taste, but one I really believe to be acid, and the other, something else.

As for something else. I think it's about 40-60% of people with burning mouth syndrome (believed to be a neurological condition) often have sour/bitter/metallic taste. In the literature it's called dysgeusia, which means "distortion of the sense of taste"-- but I don't think that term fits perfectly, because many BMS patients have no such taste when eating. So if they actually had 'dysgeusia', their sense of taste of food would be distorted. But that aside, a sour taste can have nothing to do with any sort of reflux, it can be a neurological phenomenon.

I tried a test once, feel free to give it a go. When I had a strong sour taste in my mouth, I spit a good amount into a spoon. I then had some water, cleared my palate, which temporarily relieves my sour taste. I then tasted the spit in the spoon. It had no taste, just boring old saliva. Whatever was sour was not in the saliva, as seemed to be my experience of it. In fact, that might be a good way to tell whether there is reflux in the saliva or whether the sour taste is coming from some neurological experience. If you try it please let us know. :)

DOGGBONES
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   Posted 5/31/2013 10:54 AM (GMT -6)   
drtinsac,
Thanks for your detailed response. I would say my "sour" taste comes and gos but it's there about 80% of the time, it's not a burning feeling. Most of the time my food doesn't taste different. I did read somewhere that it can be caused by bacteria from a "coated tongue", and my tongue (back) is always coated.

drtinsac
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Date Joined Apr 2012
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   Posted 5/31/2013 11:51 AM (GMT -6)   
The back of my tongue has stuff on it too. I think most people have that.

DOGGBONES
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   Posted 5/31/2013 12:22 PM (GMT -6)   
Do you mean most ill ppl like us? Most ppl I know seem to have a fairly pink tongue.

drtinsac
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Date Joined Apr 2012
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   Posted 5/31/2013 2:38 PM (GMT -6)   
I mean most everyone. I haven't looked at too many tongues up close, but seeing white gunk on them is common.
 
This may get back to the definition of "coated". What is a thin layer of gunk to one, might be considered coated by another.
 
My doctors have all looked at my tongue, as has my dentist, knowing that I'm having tongue/taste issues, and none has thought the gunk (described by one doc as normal flora of the mouth) was of any concern.

DOGGBONES
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   Posted 6/3/2013 6:39 AM (GMT -6)   
I'm going to the dentist this week, so I'll see what he has to say.

drtinsac
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Date Joined Apr 2012
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   Posted 6/3/2013 10:10 AM (GMT -6)   
Did you try tasting your spit to see if it's really about the spit, or if it's just a false taste sensation?

DOGGBONES
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   Posted 6/3/2013 10:34 AM (GMT -6)   
No not yet.....mmmm, yummy "spit taster". lol However, I am starting to think the sour taste isn't reflux but more from the thick coating on my tongue.

Warwick
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Date Joined Jun 2013
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   Posted 6/16/2013 1:39 AM (GMT -6)   
According to what I've read in several places, white growth on the back of the tongue and throat could be indicative of fungus resulting from Candida yeast overgrowth. Apparently this is usually treated by temporarily avoiding foods that Candida feeds on, e.g. sugary foods, and taking a lengthy course of probiotics to restore the bacteria/yeast balance. Prescription anti-fungal drugs are also available, but that's something you'd have to discuss with your medical practitioner.

DOGGBONES
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   Posted 6/17/2013 6:21 AM (GMT -6)   
Nope, not candida. Doc and dentist agree it's not yeast overgrowth or infection.

drtinsac
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Date Joined Apr 2012
Total Posts : 458
   Posted 6/17/2013 10:34 PM (GMT -6)   
So, it's probably a neurological thing as I believe it is with me (since the sourness has nothing to do with my saliva). Are you seeing someone who can treat neurological issues?

DOGGBONES
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Date Joined Apr 2012
Total Posts : 707
   Posted 6/18/2013 7:36 AM (GMT -6)   
Starting to think the soar taste and coated tongue are connected with the root cause being gerd. I'm not currently seeing anyone for neurological issues.

Teacherman
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Date Joined Jun 2013
Total Posts : 172
   Posted 6/18/2013 2:14 PM (GMT -6)   
My GI said to call him if I have heartburn or sour taste. I had my Barrett's ablated and am scheduled to see him soon. Both are equally bad?????
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