LPR Specialist in GA

What Is Laryngopharyngeal Reflux?

Laryngopharyngeal reflux disease, commonly referred to as LPR, is a chronic condition characterized by the backflow of stomach contents into the throat and voice box (larynx).

LPR occurs when the lower esophageal sphincter (LES), a ring of muscle that acts as a valve between the esophagus and stomach, fails to function properly. This malfunction allows stomach acid and other contents to travel upwards. This irritates the delicate tissues of the throat and larynx. Over time, this repeated exposure can lead to inflammation, discomfort, and a range of troublesome symptoms.

Symptoms of Laryngopharyngeal Reflux

The term "silent reflux" is sometimes used to describe LPR because its symptoms can be subtle and easily mistaken for other conditions that affect the upper respiratory system (like allergies, asthma, or upper respiratory infections). Symptoms can include:

• Chronic Throat Clearing
• Hoarseness
• Persistent Cough
• Globus Sensation (the feeling of a lump in your throat)
• Difficulty Swallowing
• Postnasal Drip
• Sore or Irritated Throat
• Excessive Mucus Production
• Breathing Difficulties
• Tooth Decay or Enamel Erosion (due to exposure to stomach acid)

Symptoms can vary in intensity and frequency from person to person. Some people may experience multiple symptoms, while others might only have one or two prominent issues. Because of this, symptoms alone are not enough to diagnose LPR and evaluation is required.

Laryngopharyngeal Reflux Diagnosis

As mentioned, diagnosing LPR can be challenging due to its varied presentation and similarity to other conditions. Because of these, the diagnostic process is very thorough. The first part involves a review of your medical history and a physical examination. Here’s what that entails:

• Medical History: Your doctor will begin by taking a detailed medical history, asking about your symptoms, their duration, and any factors that seem to worsen or alleviate them. They may also inquire about your diet, lifestyle habits, and any medications you're currently taking.
• Physical Examination: A thorough examination of your throat, neck, and upper respiratory tract will be conducted. The doctor may use a mirror or a small camera to visualize the back of your throat and voice box.

Laryngopharyngeal Reflux Testing

After going through your medical history and doing a physical examination, your doctor will most likely order some additional testing. This could include one or more of the following procedures:

• Videostroboscopy: This is a specialized diagnostic procedure used to assess the vocal cords (vocal folds) and laryngeal function. Videostroboscopy employs a strobe light in conjunction with a flexible or rigid endoscope to provide a detailed, slow-motion view of the vocal cords as they vibrate during speech. It allows clinicians to visualize the larynx in great detail and identify changes caused by acid reflux. It provides a "vivid picture" of even microscopic changes in the larynx due to acid exposure.
• Flexible Laryngoscopy: This procedure involves inserting a thin, flexible tube with a camera (laryngoscope) through your nose or mouth to examine your throat and voice box. It allows the doctor to look for signs of inflammation, redness, or swelling characteristic of LPR.
• Transnasal Esophagoscopy: Transnasal esophagoscopy (TNE) is a minimally invasive diagnostic procedure used to examine the esophagus and stomach. Unlike traditional endoscopy, which requires sedation and is performed through the mouth, TNE utilizes a flexible tube inserted through the nose and does not require general anesthesia. The procedure helps identify various underlying pathologies that may contribute to LPR symptoms.
• 24-hour pH Testing: This test measures the acidity levels in your esophagus and throat over a 24-hour period. It can help determine the frequency and severity of acid reflux episodes.

Laryngopharyngeal Reflux vs GERD

Laryngopharyngeal reflux is sometimes confused for gastroesophageal reflux disease (GERD). While the conditions are related, they have distinct characteristics that set them apart.

LPR primarily affects the upper digestive tract and respiratory system. GERD mainly impacts the lower esophagus and chest area. GERD often presents symptoms that are not typically present in LPR, like heartburn, regurgitation and chest pain. If you do have these symptoms, make sure to inform your doctor.