The term laryngopharyngeal reflux, or acid reflux, refers to the backflow of stomach contents into the throat. The stomach produces a variety of different chemicals, including a potent acid and substances that break down tissues, called enzymes. When such chemicals enter the throat, they have the potential for causing great damage.
Acid reflux may occur at any time, either day or night, and may be “silent.” A person may have a sensation of a sour taste in their throat or may not notice anything. Because of this, it may be difficult to diagnose.
LPR is a common disorder, and has been shown to be present in as many as 50% of all patients with voice problems. LPR may affect children and adults. While we do not know the specific cause of LPR in every patient, there are treatments available that may help reduce the impact of this disorder.
LPR is related to Gastroesophageal Reflux Disease (GERD), but is not identical to it. Patients with GERD may not have LPR, and conversely, patients with LPR may not have GERD. GERD patient typically have heartburn as their main complaint, while LPR patients may or may not have heartburn.
What are the symptoms of LPR?
LPR may show up in a variety of different ways. Most people with this problem complain of a hoarse voice and chronic throat clearing. Others complain of a feeling of a “lump” in their throat or trouble swallowing. Other symptoms may include a chronic cough, choking episodes, trouble breathing, or “rawness” in the throat.
How is LPR diagnosed?
Your doctor will begin by obtaining a history of your throat complaints. If he or she suspects that reflux is the problem, you may undergo a throat examination which will likely involve an examination of the lower throat and voice box. You may also undergo some special testing designed to look for evidence of reflux or reflux-related problems. These tests may include a pH-monitoring test and/or barium swallow.
Occasionally, your doctor may recommend that you undergo esophagoscopy. This test involves passing an endoscope into your esophagus to examine the lining. It is meant to rule out esophagitis, Barrett’s esophagus, esophageal adenocarcinoma, or other lesions which may affect the esophagus. Esophagoscopy is typically done at the NYU Voice Center with transnasal esophagoscopy.
How is LPR treated?
The treatment of LPR usually involves a combination of approaches. These may include any or all of the following: dietary and behavioral modifications, medications to reduce stomach acid, and surgery to prevent reflux.
The typical dietary and behavioral modifications are detailed in How to Reduce Acid Reflux.
Medications your doctor may advise you to take may include over-the-counter antacids or prescription medications. Most patients will require a prescription medication, at least temporarily. Typically, you will be treated with medication for a period of 6 months. If you recover at that point, you will be taken off medications. However, some patients suffer a relapse, and may need long-term therapy.
If there is no improvement with medication and dietary change or if you need long-term therapy, your doctor may recommend surgery to prevent reflux.
