Laryngopharyngeal Reflux

Many people are familiar with the traditional symptoms of acid reflux, also known as gastroesophageal reflux disease (GERD). Nagging heartburn and painful indigestion can wake you up in the middle of the night or prevent you from enjoying your favorite foods.

What most people don’t realize is that acid reflux can also cause voice problems and other throat issues.

This is known as laryngopharyngeal reflux (LPR), which is sometimes called silent reflux since people with it won’t typically experience heartburn or indigestion.

A team approach involving multiple specialties is often needed to diagnose LPR. At The Ohio State University Wexner Medical Center, not only do we have a nationally ranked ear, nose and throat (ENT) department, but we also have one of the largest voice and swallowing centers in the country with five fellowship-trained laryngologists.

We’ll also work with our award-winning gastroenterologists to diagnose laryngopharyngeal reflux, determine a cause and get you relief from symptoms quickly.

What is laryngopharyngeal reflux?

Traditional acid reflux, or GERD, happens when stomach contents, whether food or acid, travel back into the esophagus (food pipe) to cause symptoms of heartburn and indigestion.

When the muscle at the top of the esophagus — called the upper esophageal sphincter — doesn’t close properly, these acids can bubble up all the way to the throat and even nasal cavities. That’s when laryngopharyngeal reflux occurs.

Though gastroesophageal reflux disease and laryngopharyngeal reflux are related, you can have LPR but not GERD and vice versa.

Also, just like GERD can be an issue in babies, infants can develop laryngopharyngeal reflux.

What causes LPR?

Laryngopharyngeal reflux has a variety of causes; some you have control over and others you don’t. Causes and risk factors include:

• Age – You’re more prone to LPR as you age.
• Dietary habits – Eating spicy foods or drinking a lot of coffee, alcohol or carbonated beverages can contribute to this condition.
• Weight – Being overweight makes you more likely to have reflux.
• Certain anatomy anomalies – These include weak or abnormal esophagus muscles, a hiatal hernia or slow-moving stomach.
• Pregnancy
• Stress
• Lying down right after eating

If LPR occurs in babies, another cause could be growth or development issues.

LPR symptoms

Symptoms of laryngopharyngeal reflux differ from that of traditional reflux disease, and the disorder can impact your voice.

Signs of the condition include:

• Hoarseness in voice
• Constant need to clear throat
• Trouble swallowing
• Excessive mucus
• Sore throat
• Choking or wheezing
• Postnasal drip
• Difficulty singing or breathing

Laryngopharyngeal reflux treatment

Typically, laryngopharyngeal reflux is treated the same way as gastroesophageal reflux disease. Much of the management of the condition revolves around lifestyle changes you can make on your own.

Tips for helping control and prevent laryngopharyngeal reflux are:

• Eating a bland diet spread out over frequent, smaller meals
• Not eating two hours before going to bed
• Losing weight
• Cutting down on alcohol and caffeine use
• Using over-the-counter antacids, like Tums
• Propping up your head while sleeping

Sometimes prescription medications will be recommended by your doctor if your symptoms don’t improve with these changes. These medications are generally taken for roughly a month, and then you’re tapered off them.

In severe cases of LPR, surgery might be an option to correct any anatomy issues in the esophagus area.

If the reflux is left untreated, it can lead to more serious problems down the road, including:

• Chronic sore throat or cough
• Vocal cord swelling or sores
• Masses on throat
• Worsened existing conditions, such as asthma or emphysema 

Laryngopharyngeal reflux also may play a role in developing cancer of the voice box so it’s important to work with the voice and swallowing experts at the Ohio State Wexner Medical Center to treat the disease.