Laryngopharyngeal reflux

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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Laryngopharyngeal reflux
File:Illu larynx.jpg
Synonyms	Silent reflux, extraesophageal reflux disease (EERD)
Pronounce	N/A
Specialty	N/A
Symptoms	Hoarseness, chronic cough, throat clearing, dysphagia, sore throat
Complications	Laryngitis, vocal cord nodules, esophageal cancer
Onset	Can occur at any age
Duration	Chronic
Types	N/A
Causes	Gastroesophageal reflux disease (GERD)
Risks	Obesity, smoking, alcohol consumption, dietary habits
Diagnosis	Laryngoscopy, pH monitoring, esophageal manometry
Differential diagnosis	Asthma, allergies, sinusitis, vocal cord dysfunction
Prevention	N/A
Treatment	Proton pump inhibitors, H2 receptor antagonists, dietary modification, lifestyle changes
Medication	Omeprazole, Ranitidine
Prognosis	N/A
Frequency	Common
Deaths	Rare

Overview of laryngopharyngeal reflux

Laryngopharyngeal reflux (LPR) is a medical condition in which acid from the stomach flows back into the larynx (voice box) and pharynx (throat). This condition is also known as "silent reflux" because it often does not present the typical symptoms of gastroesophageal reflux disease (GERD), such as heartburn.

Pathophysiology

LPR occurs when the lower esophageal sphincter and the upper esophageal sphincter fail to function properly, allowing stomach contents to reach the larynx and pharynx. The refluxed material can cause inflammation and damage to the tissues of the larynx and pharynx, leading to symptoms such as hoarseness, chronic cough, and throat clearing.

Symptoms

Unlike GERD, LPR does not usually cause heartburn. Instead, patients may experience:

• Hoarseness
• Chronic cough
• Throat clearing
• A sensation of a lump in the throat (globus pharyngeus)
• Difficulty swallowing (dysphagia)
• Sore throat

Diagnosis

Diagnosis of LPR is often based on clinical symptoms and may be confirmed with diagnostic tests such as:

• Laryngoscopy: A procedure to visualize the larynx and pharynx.
• pH monitoring: To measure acid levels in the esophagus and throat.
• Barium swallow: An imaging test to assess swallowing and reflux.

Treatment

Treatment for LPR typically involves lifestyle modifications and medications. Lifestyle changes may include:

• Dietary adjustments to avoid trigger foods
• Elevating the head of the bed
• Avoiding eating before bedtime

Medications may include:

• Proton pump inhibitors (PPIs)
• H2 receptor antagonists
• Antacids

Prognosis

With appropriate treatment, most patients with LPR can manage their symptoms effectively. However, untreated LPR can lead to complications such as laryngitis, vocal cord nodules, and even esophageal cancer.

See also

• Gastroesophageal reflux disease
• Laryngitis
• Esophageal cancer