Skip Navigation

Reflux Disease, GERD & LPR

Reflux Disease

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 throat.

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:

  • Intermittent voice changes
  • Cough
  • Throat clearing
  • Globus (lump in the throat)
  • Excessive throat mucus
  • Swallowing problems

More serious consequences of LPR include subglottic 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 disease.

Make an Appointment

If you are suffering from reflux, GERD or LPR, call 716-WAKE or request an appointment online.


Quick Reference

The Voice Center
Find a Doctor Ways to Give
Last Updated: 05-16-2016
Wake Forest Baptist Ranked among Nation’s ‘Best Hospitals’  25 Years in a Row by U.S. News & World ReportComprehensive Cancer Centers National Designation is Renewed2017-2018 Best DoctorsNursing Magnet StatusJoint Commission Report

Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.

© Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157. All Rights Reserved.