Niagara ENT & Facial Surgeon
Dr. Babak Karamy, MD, FRCSC
Understanding Acid Reflux and Laryngopharyngeal Reflux (LPR): Symptoms, Causes, and Treatment
What is Acid Reflux?
Acid reflux, also known as gastroesophageal reflux disease (GERD), occurs when stomach acid flows back up into the esophagus, causing irritation and discomfort. The most common symptom of acid reflux is heartburn, a burning sensation in the chest. However, when acid reflux affects the throat and larynx, it is referred to as laryngopharyngeal reflux (LPR).
What is Laryngopharyngeal Reflux (LPR)?
LPR is a type of acid reflux that primarily affects the throat, larynx, and sometimes the sinuses. Unlike traditional acid reflux, LPR may not always cause heartburn, making it difficult to diagnose.
Common symptoms of LPR include:
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Persistent hoarseness or changes in voice
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Chronic cough or throat clearing
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Sensation of a lump in the throat (globus sensation)
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Excessive throat mucus
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Chronic sore throat
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Difficulty swallowing or a feeling of food getting stuck
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Throat irritation or discomfort
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Chronic sinus problems or sinusitis
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If you experience any of these symptoms, seek medical evaluation for an accurate diagnosis and appropriate treatment.
Causes and Risk Factors of Acid Reflux
Several factors can contribute to the development of acid reflux and LPR, including:
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Weak or relaxed lower esophageal sphincter (LES): The LES is a muscular valve that separates the stomach from the esophagus. When the LES fails to close properly, stomach acid can flow back up into the esophagus and throat.
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Hiatal hernia: A hiatal hernia occurs when a portion of the stomach protrudes through the diaphragm, allowing acid to escape more easily.
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Obesity: Excess weight can increase pressure on the stomach and promote acid reflux.
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Diet and lifestyle: Consuming acidic or spicy foods, caffeinated beverages, alcohol, and smoking can trigger or exacerbate acid reflux symptoms.
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Pregnancy: Hormonal changes and increased pressure on the abdomen during pregnancy can contribute to acid reflux.
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Certain medications: Some medications, such as those for asthma, allergies, or blood pressure, can relax the LES and contribute to acid reflux symptoms.
Diagnoses and Treatment of Acid Reflux
A healthcare professional will evaluate your symptoms and medical history. They may perform a physical examination to diagnose LPR.
Diagnostic tests may include:
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Laryngoscopy: A procedure to examine the throat and larynx for signs of irritation or inflammation.
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pH monitoring: A test to measure the acid levels in the throat and esophagus over a 24-hour period.
Treatment options for LPR may include:
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Lifestyle modifications: Elevating the head of the bed, avoiding trigger foods and beverages, weight loss (if applicable), and quitting smoking.
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Dietary changes: Following a low-acid diet, reducing portion sizes, and eating smaller, more frequent meals.
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Medications: Over-the-counter antacids, acid reducers, or prescription medications to reduce stomach acid production or strengthen the LES.
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Behavior and voice therapy: Techniques to modify behaviors that contribute to LPR symptoms and vocal exercises to improve vocal cord function.
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Surgical intervention: In rare cases when other treatments fail, surgery may be considered to strengthen the LES or repair a hiatal hernia.
Prevention & Self Care
You can take several steps to manage and prevent LPR symptoms:​
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Avoid trigger foods and beverages such as acidic, fatty, or spicy foods, caffeinated drinks, alcohol, and smoking. Peppermint is also a common but not recognized culprit.
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Eat smaller, more frequent meals and avoid lying down immediately after eating.
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Practice good posture and avoid slouching to reduce pressure on the abdomen.
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Maintain a healthy weight through a balanced diet and regular exercise.
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Manage stress levels through relaxation techniques and stress-reducing activities.
When to Seek Medical Attention
While many cases of LPR can be managed with lifestyle modifications and over-the-counter medications, it's important to consult a healthcare professional if you experience any of the following:
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Severe or worsening symptoms
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Difficulty swallowing or breathing
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Unintentional weight loss
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Chest pain or tightness
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Blood in vomit or stool
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Early intervention and appropriate medical care can help prevent complications and promote symptom relief.
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At Niagara ENT, we are dedicated to providing comprehensive care for acid reflux and related conditions. Our team will work closely with you to develop a personalized treatment plan to improve your acid reflux.
If you feel you have an issue with this consider a referral to Dr. Karamy.
Disclaimer
The information provided on this webpage is for educational purposes only and should not replace medical advice. Please consult with a healthcare professional for a proper diagnosis and individualized treatment recommendations.