Laryngopharyngeal reflux (LPR) is a disorder where stomach contents, including acid, back up into the throat, causing irritation. Symptoms may not include heartburn and diagnosis requires special tests. Treatment can include lifestyle changes, medication, and surgery.
Laryngopharyngeal reflux (LPR) is a disorder in which stomach contents, including stomach acid, back up into the throat. Unlike the most common form of reflux, gastroesophageal reflux disease (GERD), LPR doesn’t always cause heartburn, and its symptoms may not always be as clear-cut. Diagnosis generally requires special tests, which may include looking inside the throat with a special purpose or testing the throat’s pH over time. Treatment of laryngopharyngeal reflux can include lifestyle changes, medications, and surgery.
Normally, stomach contents, such as partially digested foods and stomach acid, are prevented from flowing backwards by special muscles in the esophagus, the tube that carries food from the throat to the stomach. With laryngopharyngeal reflux, these muscles don’t work properly, which allows stomach contents to back up through the esophagus and into the throat. Stomach acid can irritate the lining of the throat, the vocal cords and, in some cases, even parts of the sinuses.
Symptoms associated with laryngopharyngeal reflux are usually related to the irritation caused in the upper part of the throat. They may include, for example, frequent coughing or throat clearing, a hoarse voice and a feeling of excess mucus or a lump in the throat. Unlike GERD, in which stomach contents only back up into the esophagus, heartburn isn’t always present in people with LPR.
Due to the fact that symptoms of laryngopharyngeal reflux are not specific to the disease and can be caused by other health conditions, special tests are usually needed for a definitive diagnosis. One test that may be used involves inserting a scope into the back of the throat, which allows a healthcare professional to view the tissues in the throat and vocal cords. In people with LPR, these are usually red and swollen and may show signs of acid damage. Another test that can be used to diagnose LPR involves inserting a special device through the nose and down the throat to test for changes in the throat’s pH levels, which can be affected by the presence of stomach acid over about 24 hours.
Healthcare professionals may recommend lifestyle changes, medications, or surgery to help treat laryngopharyngeal reflux. Lifestyle changes can include weight loss; raising the headboard by a few centimetres; and limiting caffeine, alcohol, and spicy foods. Drugs that can be used to treat LPR may include those to reduce the formation of stomach acid, such as proton pump inhibitors, and those to block the effects of acid, such as antacids. Surgery to make it more difficult for stomach contents to flow back may be recommended in severe cases of LPR or if other treatments don’t work.
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