LPR Reflux | What is Laryngopharyngeal Reflux Disease, Symptoms

What is LPR?

Recurrent acid reflux seen with gastroesophageal reflux disease (GERD) inflames and damages the lining of the pharynx (throat) and larynx (voice box), causing a host of signs and symptoms in these areas. This is known as laryngopharyngeal reflux disease or LPR.  The classic symptoms of acid reflux such as burning chest pain (heartburn), nausea and regurgitation may not be evident and therefore LPR is associated with silent acid reflux. Both terms are used interchangeably at times.

Signs and Symptoms of Laryngopharygneal Reflux

The throat and airways are not equipped to deal with the acidic stomach contents. The delicate respiratory epithelium is easily injured by the acid and the ensuing inflammation in these areas lead to a host of signs and symptoms in these areas including :

• Chronic sore throat, especially a morning sore throat
• Chronic cough
• Hoarse voice
• Lump in the throat feeling
• Itchy throat – tickling, irritation
• Swallowing problems – painful swallowing (odynophagia) and/or difficulty swallowing (dysphagia)
• Abnormal breathing sounds

Initially the symptoms may be very mild and patients report excessive mucus in the throat, a constant need to clear the throat with a sore throat and hoarse voice only apparent in the morning and eases up by the afternoon/evening. Sometimes the gastric acid may reach as high as the posterior part of the nasal cavity. In these cases, patients may also report a post nasal drip and soreness on the roof of the mouth, especially upon waking.

Although the classic signs of GERD is not present in most cases, it may at times be present along with the symptoms mentioned above.

In untreated cases, the condition can progress to pneumonia (aspiration pneumonia) and the inflammation of the lower airways and lungs will also present with the signs and symptoms typical of these conditions. Asthmatic patients may also find an exacerbation of the condition. Shortness of breath is usually an indication of the lower airways being affected by the reflux.

LPR needs to be diagnosed and assessed by an otolaryngologist (ENT specialist). Untreated cases can lead to a host of complications. Treatment involves the same measures as outlined under Stomach Reflux and Silent Acid Reflux Treatment. Additional therapeutic measures may depend on the extent of airway involvement.

Article reviewed by Dr. Greg. Last updated on December 29, 2010