What is laryngopharyngeal reflux disease (LPRD)?
Laryngopharyngeal reflux (LPRD) occurs when stomach acid and other stomach contents travel up the esophagus and reach the throat, voice box (larynx) and vocal cords. The tissues in these areas are more sensitive than the esophagus and can become irritated by even small amounts of reflux.

Although reflux can cause throat symptoms, not everyone with these symptoms has LPRD. Your provider may recommend testing to determine whether reflux is the underlying cause.

What causes laryngopharyngeal reflux disease (LPRD)?
LPRD develops when the muscles that normally prevent stomach contents from moving backward do not function properly.

These muscles include:

  • The lower esophageal sphincter (LES), located between the esophagus and stomach
  • The upper esophageal sphincter (UES), located between the esophagus and throat

When these muscles weaken or relax inappropriately, stomach acid and other stomach contents can travel into the throat and voice box, causing irritation and inflammation.

Symptoms of laryngopharyngeal reflux disease (LPRD)
Symptoms of LPRD differ from the typical symptoms of GERD (gastroesophageal reflux disease). Many people with LPRD do not experience heartburn.

Common symptoms include:

  • Frequent throat clearing
  • Hoarseness or voice changes
  • Chronic cough
  • A sensation of a lump in the throat (globus)
  • Sore throat
  • Excess mucus or phlegm
  • Sour or bitter taste in the mouth
  • Difficulty swallowing or the sensation that something is stuck in the throat

Diagnosing laryngopharyngeal reflux disease (LPRD)
Because many conditions can cause similar symptoms, your provider may recommend testing to determine whether reflux is responsible.

Testing may include:

  • Upper endoscopy (EGD)
  • Barium swallow (esophagram)
  • Laryngoscopy
  • Ambulatory esophageal pH monitoring (Bravo or catheter-based testing)
  • pH-impedance monitoring

In some cases, your provider may recommend a trial of acid-reducing medication as part of the evaluation.

You may also be referred to an ear, nose and throat (ENT) specialist for additional evaluation.

Treatment for laryngopharyngeal reflux disease (LPRD)
Treatment focuses on reducing reflux, relieving throat irritation and preventing ongoing damage.

Treatment options may include:

  • Lifestyle modifications
  • Acid-reducing medications
  • Anti-reflux procedures or surgery for selected patients

Lifestyle modifications
Lifestyle changes are often an important part of treatment and may include:

  • Avoiding foods and beverages that trigger reflux symptoms
  • Following a healthy, mostly plant-based diet when appropriate
  • Maintaining a healthy weight
  • Avoiding tobacco products
  • Limiting alcohol
  • Eating smaller meals
  • Avoiding meals within three hours of bedtime
  • Elevating the head of the bed while sleeping
  • Sleeping on your left side when possible
  • Avoiding tight-fitting clothing around the abdomen
  • Avoiding vigorous exercise immediately after eating

Procedures and surgery
For people with confirmed reflux that does not improve with lifestyle changes and medication, additional treatment options may include:

  • Laparoscopic fundoplication
  • Magnetic sphincter augmentation (LINX®)
  • Transoral incisionless fundoplication (TIF)

Your provider will determine whether these procedures are appropriate based on your symptoms and diagnostic testing.

When to seek care
Talk with your healthcare provider if you experience:

  • Persistent hoarseness
  • Chronic cough
  • Frequent throat clearing
  • Difficulty swallowing
  • Unexplained weight loss
  • Symptoms that do not improve with treatment

Early evaluation can help identify the cause of your symptoms and determine the most appropriate treatment.

Contact us
If you have questions about laryngopharyngeal reflux disease (LPRD) or treatment options, please contact our office at 612-871-1145.