Laryngopharyngeal Reflux (LPR)

Symptoms of Laryngopharyngeal Reflux (LPR) may include:

1. Throat pain or irritation: Patients may experience throat pain or a burning sensation.
2. Hoarseness: Irritation and damage to the vocal cords due to stomach acid may result in hoarseness.
3. Coughing: Acidic substances refluxed into the throat may cause reflexive coughing.
4. Difficulty swallowing: Inflammation and swelling in the throat may lead to discomfort or difficulty swallowing.
5. Sensation of a lump: Patients may feel as though there is something stuck in their throat, especially after swallowing.
6. Symptoms of chronic laryngitis include chronic throat inflammation, vocal cord damage, etc.

Laryngopharyngeal reflux (LPR), primarily caused by Gastroesophageal Reflux Disease (GERD), occurs when stomach acid or contents reflux into the throat, irritating or damaging the mucous membranes of the throat and vocal cords. Here are some common causes and risk factors:

Gastroesophageal Reflux:

• When the lower oesophageal sphincter (LES) malfunctions and fails to close effectively, stomach acid reflux into the oesophagus and potentially reaches the throat.

Dietary Factors:

• Spicy foods, fried foods, chocolate, mint, coffee, and alcohol can all relax the LES, increasing the risk of reflux. Overeating can also burden the stomach, promoting reflux.

Lifestyle:

• Smoking weakens LES function, increasing the likelihood of gastric acid reflux. Obesity, especially abdominal obesity, increases abdominal pressure, pushing stomach acid upwards and eating immediately before lying down or after eating.

Physiological Factors:

• During pregnancy, hormonal changes and increased intra-abdominal pressure make pregnant women more susceptible to GERD and consequent LPR. Slow gastric emptying or gastric emptying abnormalities. Low pressure of the lower oesophageal sphincter.

Health Conditions:

• Individuals with GGERD. Certain diseases, such as diabetes, gastrointestinal disorders, etc., may affect gastric emptying.

Medication Use:

• Certain medications such as painkillers, calcium channel blockers, and certain antidepressants may affect LES function, increasing the risk of reflux.

Anatomical Abnormalities / Structural Abnormalities:

• Anatomical abnormalities such as hiatal hernia may also lead to gastric acid reflux.

Diagnosis

Diagnosing laryngopharyngeal reflux (LPR) typically relies on symptoms and clinical presentation, but the following tests may be required to confirm the diagnosis:

• Laryngoscopy: Examining the condition of the throat and vocal cords.
• 24-hour pH monitoring: Measuring acidity in the oesophagus to determine if acidic substances are refluxing into the throat.
• Esophagogastroduodenoscopy (EGD): Examining the oesophagus and stomach condition to identify potential reflux causes.
   

Treatments

Treating laryngopharyngeal reflux (LPR) typically involves a comprehensive approach, including:

• Lifestyle adjustments: Improving dietary habits, avoiding consumption of irritating foods, weight loss, and smoking cessation.
• Medication therapy: Using proton pump inhibitors (PPIs), H2 receptor antagonists, and other medications to reduce gastric acid secretion.
• Vocal cord care: Avoiding overuse