What Is Laryngopharyngeal Reflux (LPR)?

The term reflux comes from a Greek word that means “backflow”. It usually refers to the backflow of stomach contents. Normally, once the things we eat reach the stomach, digestion should begin without stomach contents coming back up again……..refluxing.

Laryngopharyngeal Reflux (LPR) refers to the backflow of food or stomach acid coming all the way back up into the larynx (the voice box) or the pharynx (the throat). LPR can occur day or night, even if a person hasn’t eaten a thing.

Many People With LPR Don’t have Heartburn…..Why Is That?

Some people experience discomfort such as heartburn, but not everyone with reflux has a lot of heartburn or indigestion. In fact, many people with LPR usually do not have heartburn. This is because the material that refluxes does not stay in the esophagus for very long. In other words, the acid does not have enough time to irritate the esophagus and cause heartburn. This is why LPR is called “Silent Reflux”.

However, if even small amounts of refluxed material come all the way up into the throat, other problems can occur. This is because, compared to the esophagus, the voice box and throat are much more sensitive to injury and irritation from stomach acid. LPR is difficult to diagnose because the symptoms are different than those associated with gastroesophageal reflux disease (GERD).

How Do I Know If I Have LPR?

Chronic hoarseness, throat clearing, and cough, a feeling of a lump in the throat or difficulty swallowing may be signs that you have LPR. Some people have hoarseness that comes and goes, and others have a problem with too much nose and throat drainage; that is, too much mucus or phlegm.

Some people have heartburn too. If you have any of these symptoms, and especially if you smoke, you should ask your doctor about LPR. The specialist who most often treats people with LPR is the Otolaryngologist (Ear, Nose and Throat physician).

If your doctor thinks that you have LPR, they will probably perform a throat exam first and look at the voice box. If this area looks swollen and/or red, you may have LPR. At that point, your doctor may order some tests or recommend a specific treatment.

Posted by H. Craig Price, MD