Laryngopharyngeal reflux (LPR) occurs when digestive juices flow back from the stomach into the throat. Not to be confused with gastroesophageal reflux (GERD), which affects the esophagus, LPR affects the airways and the voicebox. LPR is a chronic condition that may be persistent or may come and go intermittently. Treatment includes medications, lifestyle changes to prevent acid reflux, and sometimes surgery.
LPR vs. GERD
Laryngopharygeal reflux is not the same as GERD, though most people do not understand the difference. Acid reflux is the root of both conditions, but the reflux affects the body in different ways. People who have GERD primarily display irritation and discomfort in the esophagus and heartburn, whereas this is not always the case for LPR sufferers. LPR is sometimes called "silent reflux," according to the NYU Voice Center, because the reflux may occur without the burning sensation. Some people who have LPR also suffer from GERD, and vice versa, but the reflux disorders are two distinct conditions.
Symptoms
The symptoms of LPR are related to the larynx and the airways of the throat. People who suffer from this form of reflux may have a hoarse voice at times and have trouble breathing. The backup of acids into the throat can feel like a permanent lump in the throat, causing a person to develop a chronic cough. Clearing the throat and frequent swallowing to try to get rid of the acids may also be symptoms of LPR. The NYU Voice Center reports that patients may complain of a sore throat that feels constantly raw.
Diagnosis
Diagnosis of LPR may begin with a barium swallow and other testing that is usually performed to diagnose GERD. If a person does not experience heartburn, yet still suffers from the chronic cough and hoarseness consistent with LPR, additional examinations and testing may be performed by an otolaryngologist, a specialist who deals with the ears, nose and throat. Specialists may use a probe to examine the lower throat and larynx to determine if reflux is the cause of the problems.
Medical Treatment
Medications to limit or stop stomach acid production are used to treat LPR. Drugs called proton pump inhibitors are generally prescribed on a three-times daily schedule to protect the larynx from further damage. Medical treatment for LPR can span over several months. James A. Koufman states in the September 2002 issue of the "Ears, Nose & Throat Journal" that some patients still feel the effects of LPR after four months of treatment.
Surgery to correct reflux may be an option for some sufferers of severe LPR. Reflux stems from the weakening of the upper esophageal sphincter, a muscle a the base of the throat that normally keeps acids out of the throat.
Lifestyle Adjustments
LPR can also be treated through diet and lifestyle adjustments and is essentially the same treatment that is recommended for heartburn sufferers. Certain foods cause the problem and should be eliminated or greatly reduced. Offending items include caffeine, chocolate, peppermint, garlic, onion, spicy foods and foods that are high in fat. Eating smaller meals more frequently throughout the day can help prevent reflux as well.
Gravity helps stomach acids stay in the stomach. People who suffer from LPR, GERD or both should avoid going to bed right after eating a large meal; staying upright for two hours or longer can help reduce reflux. Raising the head of the bed also helps prevent stomach acids from flowing back into the throat.
