What is Laryngopharyngeal Reflux (LPR)?
Acid reflux occurs when acidic stomach contents flow up into the esophagus, the swallowing tube that leads from the back of the throat to the stomach. When acid repeatedly “refluxes” from the stomach into the esophagus alone, it is known as gastroesophageal reflux disease (GERD). However, if the stomach acid travels up the esophagus and spills into the throat or voice box (called the pharynx/larynx), it is known as laryngopharyngeal reflux (LPR).
What Are the Symptoms of GERD and LPR?
Many patients with LPR do not experience classic symptoms of heartburn related to GERD. Some experience both GERD and LPR symptoms.
Regurgitation (a surge or rush back) of stomach contents
Frequent throat clearing or coughing
A bitter taste
A sensation of burning or throat soreness
Something “stuck” or a “lump” in the back of the throat
Hoarseness or change in voice
Drainage down the back of the nose (post-nasal drip)
Choking episodes (can sometimes awaken from sleep)
Difficulty breathing if the voice box is affected
What Are the Treatment Options?
Options for treatment include lifestyle and dietary modifications (see below), medications, and, rarely, surgery. Medications that can be prescribed include antacids, proton pump inhibitors, and foam barrier medications. To be effective, these medications are usually prescribed for at least one month, and may be tapered off later after symptoms are controlled. For some patients, it can take two to three months of taking medication(s) to see effects.
What Changes Can I Make to Prevent GERD and LPR?
Lose weight. Obesity increases reflux.
Cut down or stop smoking tobacco products. Nicotine relaxes the sphincter that keeps acid in the stomach.
Wear clothing that is looser around the waist.
Eat multiple (3-4), small meals a day, instead of two to three large ones, and eat slowly.
Avoid eating and drinking within two to three hours of bedtime.
Avoid chewing gum or sucking on hard candies. They increase the amount of swallow air, which leads to belching and reflux.
Elevate the head of the bed when sleeping. You can do this with a wedge pillow or blocks under the headposts.
Avoid the following foods and beverages:
Dairy and creamed foods or soups
Caffeinated and carbonated beverages (coffee, tea, soda)
Citrus fruits and juices (grapefruit, orange, pineapple)
For more information, check out: