Laryngopharyngeal reflux (LPR), is a condition in which stomach acid travels upwards into the throat. These acid “refluxes” irritate the throat and cause a variety of symptoms.
Symptoms of LPR
Symptoms associated with LPR include:
- Feeling a lump in the throat
- Excess mucus
- Post nasal drip
- Throat clearing
- Throat pain
- Difficulty swallowing
- Cough
- Voice changes
LPR is similar to gastroesophageal reflux disease (GERD), except individuals typically do not experience the heartburn and indigestion associated with GERD. For this reason, LPR is often called “silent reflux.”
How LPR is Treated
LPR is primarily treated by behavioral changes, which are centered around avoiding acidic foods and eliminating behaviors that contribute to acid reflux.
To prevent LPR, patients should avoid:
- Teas, except for chamomile tea
- Coffee
- Caffeine
- Chocolate/Mints
- Alcohol
- Carbonated beverages
- Citrus including tomatoes, oranges, and grapefruits
- Garlic and onions
- Spicy foods
- Fattening foods with butter or oil
- Deep fried foods
- Overeating, because it causes the stomach to bloat and increases pressure on the stomach. This, in turn, makes it easier for food to reflux towards the throat.
Lying down within three hours after a meal can cause stomach contents to reflux. Another important rule to follow is to avoid eating for three hours before meals. However, if lifestyle changes fail to reduce symptoms, patients may need medication.
A proton pump inhibitor (PPI) is a medication that decreases the amount of acid produced by the stomach. Patients should take proton pump inhibitors on an empty stomach, wait thirty minutes and then eat food to activate the medication. It’s important to follow these instructions exactly to ensure the medication works properly.
PPIs have been used to effectively treat PPI for many years and are considered safe. However, they may carry risk of osteoporosis and hip fracture in older individuals. They can also interact with clopidogrel (Plavix). Proton pump inhibitors may also increase the risk of developing c. dificile, a type of bacterial infection.
Generally, however, LPR is treatable, and qualified physicians will take steps to identify the cause of a patient’s symptoms and provide a diagnosis. Once a diagnosis is made, patients with LPR can begin the treatment process.