Laryngopharyngeal / Gastroesophageal reflux disease

Laryngopharyngeal reflux, also known as LPR, is a condition that can occur in patients who have been diagnosed with gastroesophageal reflux disease, also known as GERD. Acid from the stomach rises upward, towards the esophagus, and enters the back of the throat. Patients with LPR report experiencing a bitter taste and the feeling that something is caught in the back of their throat. In some cases, LPR can cause breathing difficulties.

Causes of LPR

It is believed that the abnormal relaxation of the lower esophageal sphincter, or LES, which allows the liquid to pass back up to the esophagus, may contribute to the cause of the condition. The back flow of acid from the stomach into the esophagus enters the lower throat and voice box.

Symptoms of LPR

The symptoms of LPR are isolated to the throat. Patients experiencing symptoms of LPR may experience the following:

• Difficulty breathing
• Hoarseness of the voice
• Difficulty swallowing
• A feeling that something is caught in the back of the throat
• Chronic cough
• Throat clearing
• Sore throat
• Heartburn
• Indigestion
• Increased or thickened mucus

Diagnosis of LPR

Diagnosis of LPR is usually made after a thorough medical and physical examination of the throat. Testing, to confirm diagnosis of LPR, may include the following:

• Barium swallow study
• Esophageal acid testing
• Endoscopic examination of the throat and vocal cords

Treatment of LPR

There are numerous treatment options that may reduce the severity and frequency of the symptoms of LPR. They include lifestyle changes, medications, surgery or complementary and alternative therapies to control symptoms. Some of the treatments include the following:

• Avoiding lying down for 3 hours after a meal
• Wearing clothing that is not snug
• Losing weight
• Keeping the upper body slightly elevated while sleeping to keep reflux down
• Eating small, frequent meals
• Avoiding foods known to promote reflux such as chocolate, peppermint, citrus food, spicy food, coffee and alcohol
• Stopping smoking
• Taking proton pump inhibitors
• Undergoing surgery, for severe cases

Gastroesophageal Reflux Disease (GERD)

Reflux (backflow of gastric contents) into the throat of stomach acid can cause a variety of symptoms in the esophagus (swallowing tube) as well as in the throat. Hoarseness (chronic or intermittent), swallowing problems, a foreign body sensation, or throat pain are common symptoms of gastric acid irritation of the throat, called laryngopharyngeal reflux disease (LPRD). LPRD is difficult to diagnose because approximately half of the patients with this disorder have no heartburn symptoms which traditionally accompany gastroesophageal reflux disease (GERD).

Your gastric acid can flow up to the throat at any time. The at-night aspect of LPRD is thought to be the hardest to diagnose because there are usually no specific symptoms while the reflux occurs. Consequently, patients will awake with throat irritation, hoarseness, and throat discomfort without knowing the cause. An examination of the throat by an otolaryngologist will determine if stomach acid is causing irritation of the throat and voice box.