What is Laryngopharyngeal Reflux?
The term reflux comes from a Greek word that means “backflow.” It refers to “the back flow of stomach contents.” Normally, once the things that we eat reach the stomach, digestion should begin without the contents of the stomach coming back up again, i.e., refluxing. Some people have reflux just into the esophagus (the swallowing tube that joins the throat to the stomach). If this happens frequently, a person may develop heartburn, (a painful, burning sensation in the chest). This condition is called gastroesophageal reflux disease (GERD). The term Laryngopharyngeal Reflux (LPR) refers to the backflow of stomach contents all the way up the throat, into the larynx and pharynx (the voice box and throat). LPR can occur during the day or night, and many people who have LPR will not have heartburn; so LPR is sometimes called silent reflux.
How is LPR Treated?
Treatment for LPR should be individualized, and your doctor will suggest the best treatment for you. Generally, there are several treatments for LPR but diet is very important, and reflux treatment should be customized for each patient based upon his/her symptoms and findings. Most people with LPR need to modify how and when they eat, as well as take some medication to get well. Sometimes, nonprescription liquid antacids are recommended. Your doctor also may give you a prescription. LPR is usually treated with medications called PPIs that reduce stomach acid. In addition to PPIs, sometimes a second type of medication (like Zantac, ranitidine, or Pepcid) is recommended before bedtime. For people who have symptoms after meals, chewing gum can help, too. Finally, a low-acid low-fat diet helps as much as anything. Most patients with LPR require some treatment most of the time, and some people need life-long medicine. But some people do recover completely or at least have LPR-free intervals of many years.
Without treatment, LPR can be serious, even dangerous. For people with LPR who don’t improve with medication or who are allergic to reflux medicines, stomach surgery called lap fundoplication, that restores function of the main esophageal valve, may be recommended.