Laryngopharyngeal Reflux (LPR): Causes, Symptoms, and Treatment
Laryngopharyngeal reflux, or LPR for short, is a condition where stomach acid makes its way back up into the throat, voice box (larynx), and pharynx. Unlike the more common acid reflux or GERD, LPR often sneaks up on you without the telltale heartburn, making it trickier to spot. Instead, people dealing with LPR might find themselves grappling with a nagging throat irritation, a persistent cough, hoarseness, or an annoying need to clear their throat all the time.
Sometimes referred to as “silent reflux,” LPR can create significant discomfort in the throat and voice without the burning chest pain that usually comes with acid reflux. If it goes untreated, it could lead to long-lasting changes in your voice, difficulties with swallowing, or even complications in the upper airway.
What Causes Laryngopharyngeal Reflux?
- Weak muscle function in the esophagus or sphincter.
- Dietary habits such as eating spicy, fatty, or acidic foods.
- Lifestyle factors like late-night meals, smoking, or alcohol use.
- Obesity, which increases pressure on the stomach and encourages reflux.
- Hiatal hernia, where part of the stomach pushes upward into the chest.
- Stress and poor sleep, which may worsen reflux symptoms.
Symptoms of Laryngopharyngeal Reflux
- Hoarseness or voice changes – especially noticeable in the morning.
- Chronic throat clearing – feeling of constant mucus in the throat.
- Persistent cough – often dry and worse at night.
- Globus sensation – the feeling of a lump or something stuck in the throat.
- Difficulty swallowing (dysphagia) – food or liquids feeling like they get “stuck.”
- Sore throat or burning – especially after meals or upon waking.
- Excess throat mucus – leading to frequent swallowing or clearing.
- Bad breath – caused by acid irritation and mucus buildup.
Treatment and Management of Laryngopharyngeal Reflux
1. Lifestyle and Home Remedies
- Try eating smaller meals and steer clear of heavy dinners.
- Give yourself a break after eating; wait at least 2–3 hours before lying down.
- Propping up the head of your bed can help ease nighttime reflux.
- Keeping a healthy weight can lessen the pressure on your stomach.
- Quitting smoking and cutting back on alcohol can really boost your throat health.
- Don’t forget to stay hydrated—water helps wash away acid and mucus.
2. Dietary Modifications
- Watch out for these foods that often trigger LPR:
- Spicy dishes, fried foods, and greasy meals.
- Caffeine, chocolate, and fizzy drinks.
- Citrus fruits, tomatoes, and anything with vinegar.
- Some people may also react to too much dairy.
- It’s a good idea for patients to keep a food diary to spot and avoid their personal triggers.
3. Medications
Doctors might suggest:
- Proton Pump Inhibitors (PPIs) to cut down on stomach acid production.
- H2 Blockers to lower acid release, often taken at night.
- Antacids for quick relief from symptoms.
- Medications work best when paired with lifestyle and dietary changes.
4. Voice and Swallowing Therapy
- If LPR has impacted your voice or swallowing, working with a speech-language pathologist could be beneficial. These sessions can help you use your voice more effectively and ease throat strain.
5. Surgical Options
- For severe cases that don’t respond to medications, procedures like fundoplication (which tightens the esophageal sphincter) might be an option.
- However, this is less common and usually considered only when other treatments haven’t worked.
