What Is LPR? Understanding Silent Reflux

Laryngopharyngeal reflux (or LPR) is a condition in which stomach juice refluxes up through the esophagus into the back of the throat, causing irritation in the vocal cords and lungs. Normally when we swallow, food and liquid travel down our esophagus and enter the stomach through a valve that opens to allow food and liquid into the stomach for digestion by stomach acid. That valve is often referred to as the lower esophageal sphincter, and when it’s working as it should the whole digestive process goes swimmingly. When the lower esophageal sphincter is too loose, however, it opens inappropriately and allows stomach acid to “back up” or reflux into the esophagus.

When reflux happens in the esophagus, most people experience it as painful heartburn. This type of reflux is typically referred to as “acid reflux”, and it’s fairly common in the US, especially in patients with GERD. Acid reflux isn’t the only type of reflux, though. Laryngopharyngeal reflux happens when stomach acid backs up all the way into the voice box (larynx) or throat (pharynx). The larynx and pharynx are much more sensitive to stomach acid than the esophagus is, and this type of reflux results in a myriad of symptoms. Laryngopharyngeal reflux is often referred to as “silent reflux” because in many patients it doesn't present with typical reflux symptoms like heartburn, making it difficult to identify.

What Are Common Symptoms Of Silent Reflux?

 LPR is common in patients with GERD, and can present with or without typical GERD symptoms. Most patients with LPR don’t suffer from heartburn (although it is possible), but rather from the following symptoms:

·      Hoarseness of voice (either chronic or intermittent)

·      Continual throat clearing or irritation

·      Ear pain

·      Post-nasal drip

·      Chronic cough

·      Frequent throat clearing

·      Shortness of breath

·      Lump-in-the-throat sensation

·      Sour or bitter taste in the mouth

·      Recurring sinus infections that aren’t due to other causes

·      Difficult or painful swallowing

How Can I Treat My LPR?

Treatment approaches for patients with LPR are similar to the ones used for treating GERD. Treatment plans vary based on each individual case, but will generally include one or more of the following options:

·      Lifestyle changes to reduce reflux

·      Medication to reduce stomach acid

·      Surgery to prevent reflux

To learn more about each specific option, visit our GERD treatment page.