Laryngopharyngeal reflux (LPR) or silent reflux is a medical condition characterized by the backflow of stomach acid into the larynx and pharynx.

Unlike gastroesophageal reflux disease (GERD), LPR affects the throat and voice box instead of the esophagus. The symptoms of LPR include hoarseness, chronic cough, throat clearing, difficulty swallowing, and a feeling of a lump in the throat. If left untreated, LPR can cause long-term damage to the throat, voice, and lungs.

Causes of Laryngopharyngeal Reflux

The causes of LPR are similar to those of GERD. The lower esophageal sphincter (LES), a muscle at the bottom of the esophagus that prevents the backflow of stomach contents, becomes weak, allowing the stomach acid to flow back up.

This can be due to several factors, including:.

Hiatal hernia, where part of the stomach pushes up into the chest cavity
Obesity or excessive weight gain, which puts pressure on the LES
Pregnancy, which also puts pressure on the LES
Smoking, which weakens the LES and damages the throat and lungs
Alcohol and caffeine consumption, which irritate the throat and relax the LES
Eating spicy, acidic, or fatty foods, which trigger reflux
Stress, which can increase acid production and weaken the LES

Diagnosis of Laryngopharyngeal Reflux

Diagnosing LPR can be challenging because the symptoms are not always visible and can mimic other conditions. Your doctor may perform several tests, such as:.

Endoscopy, where a thin, flexible tube is inserted through the nose or mouth to examine the upper digestive tract
pH monitoring, where a probe is placed in the esophagus to measure the acidity levels over 24 hours
Manometry, where a tube is inserted through the nose or mouth to measure the pressure and function of the esophagus and LES
Barium swallow, where you drink a contrast solution that shows up on X-rays to detect any abnormalities in the upper digestive tract

Treatment of Laryngopharyngeal Reflux

Treating LPR involves a combination of lifestyle changes, medications, and in severe cases, surgery. The following are some ways to manage LPR:.

Lifestyle Changes

There are several lifestyle changes you can make to relieve LPR symptoms:.

Elevate the head of your bed by 6-8 inches to prevent stomach acid from flowing back up
Avoid smoking, alcohol, and caffeine
Reduce stress through relaxation techniques like yoga and meditation
Avoid eating 3-4 hours before bedtime, and smaller and more frequent meals throughout the day
Avoid spicy, acidic, and fatty foods
Lose weight if you are overweight or obese

Medications

Your doctor may prescribe medications to reduce acid production in the stomach and protect the mucous membranes in the throat:.

Proton pump inhibitors (PPIs) like omeprazole, esomeprazole, and lansoprazole, which reduce acid production in the stomach
H2-receptor blockers like ranitidine and famotidine, which also reduce acid production in the stomach but have fewer side effects than PPIs
Antacids like calcium carbonate and magnesium hydroxide, which neutralize stomach acid and provide immediate relief from heartburn
Prokinetics like metoclopramide, which speed up gastric emptying and strengthen the LES

Surgery

If lifestyle changes and medications fail to alleviate LPR symptoms, your doctor may recommend surgery:.

Nissen fundoplication, where the top of the stomach is wrapped around the LES to create a barrier against reflux
EndoCinch, where sutures are placed around the LES to tighten it and improve function
Linx, where a small, magnetic ring is placed around the LES to prevent the backflow of stomach acid

Preventing Laryngopharyngeal Reflux

Preventing LPR is possible by adopting the following habits:.

Avoiding trigger foods and drink
Eating smaller meals and avoiding late-night snacking
Managing stress through relaxation techniques
Losing weight if you are overweight or obese
Quitting smoking and avoiding alcohol and caffeine
Elevating the head of your bed by 6-8 inches
Getting regular exercise to maintain a healthy weight and improve digestion

Conclusion

Laryngopharyngeal reflux is a chronic condition that can affect your quality of life. It is important to seek medical attention if you experience any symptoms of LPR to prevent long-term complications.

A combination of lifestyle changes, medications, and surgery can effectively manage LPR and relieve symptoms. With proper care and prevention, you can conquer laryngopharyngeal reflux for good.