Laryngopharyngeal Reflux Disease

Laryngopharyngeal reflux (LPR) is when stomach acid moves up into your throat. Although you may experience heartburn or indigestion, many patients DO NOT have these symptoms. For this reason we sometimes call LPR "silent reflux". Common complaints in patients with LPR include:

Mucus or "drainage" in the back of the throat

Lump sensation in the throat

Throat clearing or chronic cough

Tickling or burning sensation in throat

Difficultly swallowing

Ear pain or discomfort

Sore throat

Hoarseness or voice change

Prolonged vocal warm-up (singers)

Loss of high range voice (singers)

Most often LPR is diagnosed by questioning the patient about symptoms and by physical exam. The exam may involve looking down your throat and at your vocal cord area with a special telescope. Swelling, inflammation, and vocal cord damage are often seen. Occasionally a special pH (acid) probe test may be required.

TREATMENT

LPR is first treated with anti-acid medications and lifestyle/diet changes. The lifestyle changes are very important, and MUST be followed to expect relief of symptoms. Treatment includes:

MEDICATIONS: In most cases a "proton pump inhibitor" (PPI) will be prescribed (such as Nexium, Prevacid, Protonix, Prilosec, or Aciphex). Follow your doctors instructions carefully, and be sure to take the medicine 30 minutes to 1 hour BEFORE meals.

MEAL TIMES: Do not eat at least 2 hours before going to bed.

HEAD ELEVATION: Elevate the head of your bed 4-6 inches (use blocks or bricks) or use a wedge pillow. This is usually for patients with nighttime reflux and morning symptoms

LOSE WEIGHT: If you are overweight, losing weight will help. Avoid tight fitting clothing.

THINGS TO AVOID OR CUT BACK:

CAFFEINE: Avoid caffeinated coffee, tea, and soft drinks. Soft drinks are particularly bad because they are also acidic and the carbonation leads to belching of acid into the throat.

CHOCOLATE

MINTS: Including spearmint, peppermint and cinnamon.

ALCOHOL: Especially in the late evening or near bedtime.

SMOKING: Smoking further irritates your vocal cords and can lead to more serious conditions.

FRIED, FATTY, OR SPICY FOODS: Avoid these and any other foods if they are known to give you heartburn or indigestion. Garlic and onions can also be bad for acid reflux.

Revised 2/08