LARYNGOPHARYNGEAL REFLUX

Laryngopharyngeal reflux occurs when acid from the stomach travels towards the throat and mouth. “Reflux” describes the ‘backwards flow’ of acid into the throat. Laryngopharyngeal reflux is sometimes referred to as “LPR” for short.

Laryngopharyngeal reflux is often called silent reflux because patients do not experience the ‘typical’ symptoms of reflux such as heartburn, belching and chest pain. The acid irritates the structures of the larynx (voice box) and pharynx (throat).

Symptoms of laryngopharyngeal reflux
Hoarseness
Throat clearning
“Lump in the throat sensation”
Cough
Increased phlegm
Throat pain
Difficulty swallowing

Diagnosis of laryngopharyngeal reflux starts with an excellent history. A physician may ask a patient to fill out a questionaire called the reflux symtpom index to help in making the diagnosis. The physical examination focuses on evaulation of the throat and includes a stroboscopic examination of the larynx. In this exam a camera is inserted through the nose or through the mouth to evaluate the voice box and throat. pH monitoring and impedance testing may be ordered to confirm the diagnosis

Treatment of laryngopharyngeal reflux begins with dietary and lifestyle changes. Individuals should avoid foods high in acid including coffee, caffeine, citrus, chocolate, garlic, tomatoes, onions, alcohol and spicy foods. Acid reflux is often associated with being obesity, and weight loss and shown to help laryngopharyngeal reflux symptoms. Acid reflux medications such as proton pump inhibitors or H2 blockers may be initiated as well.

Esophagoscopy is often indicated to evaluate for lesions of the esophagus. Acid may cause changes in the esophagus which lead to further symptoms.