Laryngopharyngeal reflux (LPR) is a condition where stomach acid travels up into the throat and voice box, causing irritation and inflammation.

It is also known as silent reflux because it does not always cause the typical symptoms of gastroesophageal reflux disease (GERD), such as heartburn and indigestion.

Causes and Risk Factors

The lower esophageal sphincter (LES) is a muscle at the bottom of the esophagus that opens to allow food and liquid to enter the stomach and closes to prevent them from coming back up.

When the LES does not work properly, stomach acid can flow back into the esophagus and throat.

Frequent occurrence of LPR can be caused by the following factors:.

Obesity
Smoking
Alcohol consumption
Eating large meals
Lying down after eating
Tight clothing
Hiatal hernia
Pregnancy
Stress

Symptoms

The symptoms of LPR can be different from those of GERD. They include:.

Hoarseness
Chronic cough
Postnasal drip
Sore throat
Difficulty swallowing
Feeling of a lump in the throat
Ear pain
Bad breath

Diagnosis

A diagnosis of LPR is usually made based on the patient’s symptoms and medical history. A doctor may also perform a physical examination of the throat and voice box, as well as tests such as:.

pH monitoring: measures the amount of acid in the esophagus
fibre-optic endoscopy: allows the doctor to see the throat and voice box
barium swallow: shows the flow of food and liquid through the esophagus
laryngeal electromyography: measures the muscles of the throat and voice box

Treatment

The goal of treatment for LPR is to reduce the amount of stomach acid that comes into contact with the throat and voice box. This can be done through the following methods:.

Lifestyle changes: avoiding trigger foods, losing weight, quitting smoking, and avoiding alcohol
Dietary changes: eating smaller meals, avoiding late-night snacks, and avoiding foods that trigger symptoms
Medications: proton pump inhibitors (PPIs) and H2 blockers can reduce stomach acid production
Surgery: a procedure called fundoplication can strengthen the LES to prevent reflux