Gastroesophageal reflux disease (GERD) is an abnormal flow of stomach contents into the esophagus. When that stomach acid travels up the esophagus and then into the throat, it is called laryngopharyngeal reflux (LPR).

LPR Symptoms

Many people with LPR do not have the typical GERD symptoms of heartburn and regurgitation. Instead, symptoms of LPR may include:

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

Serious consequences of LPR include subglottic stenosis, spasm of the vocal folds, granulomas and cancer.

LPR Diagnosis

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.

LPR Treatment

There are several lifestyle modifications that you can make to limit your reflux.

  • Quit smoking
  • If you are overweight, weight loss can help
  • Limit alcohol and caffeine
  • Avoid fatty foods
  • Eat smaller meals
  • Avoid tight abdominal clothing
  • Do not lie down within 3 hours of eating (or within 20 minutes of drinking)
  • Avoid foods that seem to make your reflux worse
  • Some people find that raising the head of their bed helps their symptoms. You may also find it helpful to avoid lying on your right side.

In addition to lifestyle changes, your doctor may prescribe medication. 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.