Reflux Disease, GERD & LPR
Reflux is the backflow of stomach contents into
the esophagus and even into the throat. Gastroesophageal reflux disease (GERD)
is an abnormal flow of stomach contents into the esophagus, and laryngopharyngeal
reflux (LPR) is an abnormal flow of stomach and esophageal contents into the
Gastroesophageal Reflux Disease (GERD)
GERD is the disease that most
Americans think of as “reflux.” The most common symptoms are heartburn and
regurgitation. More atypical symptoms, such as cough, may occur in the absence
of heartburn or regurgitation symptoms.
The esophagus is designed to
resist injury from reflux, and GERD symptoms do not typically occur until there
is excessive exposure of the esophagus to stomach contents (for example, more
than 50 reflux episodes in a 24 hour period). This type of exposure can lead to
esophageal erosions, strictures, Barrett’s esophagus and even cancer. While acid is one of the harmful components
of reflux, a more important component to GERD is the digestive enzyme pepsin, which is
only active in an acidic environment.
The most effective reflux
medications only control acid and do not actually prevent GERD from
occurring. Even when the reflux is not acidic, it can still cause symptoms
(sometimes called non-acid reflux). While lifestyle modifications are
particularly important in the treatment of GERD, some people may choose to have
an abdominal surgery.
Laryngopharyngeal Reflux Disease (LPR)
LPR may be present in up to 50% of
people with voice problems. The voice box and throat are very susceptible to
damage from acid and pepsin, and as few as three episodes a week can cause
damage resulting in LPR. This explains why many people with LPR do not have the typical GERD
symptoms of heartburn and regurgitation.
Symptoms of LPR may include:
- Globus (lump
in the throat)
More serious consequences of LPR
stenosis, spasm of the vocal folds, granulomas and
cancer. Acid production needs to be more tightly controlled for LPR than for
GERD, so treatment is often very aggressive (sometimes double or triple the
dosage of medication used for GERD). LPR symptoms may not start to improve
until several months after treatment begins.
LPR can be diagnosed based on laryngeal
examination and symptoms. Sometimes a trial of reflux medication is used to
make the diagnosis. 24-hour pH testing is often used to diagnose reflux
Make an Appointment
If you are suffering from reflux, GERD or LPR, call 716-WAKE or request an appointment online.