Laryngopharyngeal Reflux (LPR)
What is Laryngopharyngeal Reflux (LPR)?
Laryngopharyngeal reflux is the backflow of stomach acid into the esophagus, and then into the throat. In Gastroesophageal reflux disease (GERD), the acid irritates the tissues of the esophagus (the feeding tube that connects the stomach and the throat) and the symptoms are primarily heartburn and indigestion. In LPR, the acid spends very little time in the esophagus and rises to the level of the throat and larynx (voice box) and causes swelling and irritation in these areas.
How is LPR treated?
Treatment for LPR includes a combination of behavioral modification and medical therapy. Behavioral modifications include weight reduction, avoidance of late night eating and avoidance of products/foods that trigger acid reflux. Common triggers of acid reflux include alcohol, tobacco, spicy foods, fatty foods, caffeine, chocolate and peppermint. Additionally, sleeping with the head of the bed elevated may be helpful.
The goal of medical therapy in LPR is to reduce the production of stomach acid and its affects. This is primarily achieved through a class of medications called proton-pump inhibitors (prilosec, nexium, aciphex, prevacid, protonix) as well as H2 blockers (pepcid, zantac) and antacids (maalox, mylanta). Once the diagnosis of LPR has been made, a trial of one or more of these medications is initiated for several weeks to months. The doses and frequency of these medications are often adjusted based on the patient’s response to treatment.