Gastroesophageal & Laryngopharyngeal Reflux
The diagnosis of gastroesophageal reflux as well as the related problem of laryngopharyngeal reflux is becoming more common. Gastroesophageal Reflux (GERD), specifically refers to the condition of acid refluxing from the inside of the stomach back into the esophagus. Patients with this condition typically present with symptoms of fullness, heartburn, as well as indigestion. Most patients with symptoms of gastroesophageal reflux are aware of ongoing digestive issues leading to their symptoms.
The other associated condition, Laryngopharyngeal Reflux (LPR), is slightly different in presentation. The condition specifically refers to the flow of acid content from the stomach all the way up into the larynx. Since the larynx does not have any native protective mechanisms against acid content from the stomach, immediate symptoms of fullness, hoarseness, sensation of foreign body in the throat, as well as chronic cough may ensue. Most patients with laryngopharyngeal reflux are typically not aware of indigestion or heartburn issues in the vicinity of the stomach. The reason for this is that we have much more protective mechanisms in place to protect us from incidental spillage of acid material in the nearby regions of the esophagus. However, the larynx has no protective mechanisms against acid contents and any small amount of acid quickly affects the mucosal membranes and the function of our larynx.
Patients with suspected diagnosis of laryngopharyngeal reflux are best served by seeing their ear, nose and throat specialist promptly. A careful examination, including nasolaryngoscopy and examination of the mucosal membranes of the throat is best at diagnosing any type of reflux concerns. Most patients with laryngopharyngeal reflux can be initially treated with acid-lowering medications as well as diet precautions to prevent further reflux. In some cases, referral might need to be made to the gastrointestinal specialist for further investigation into causes for persistent symptoms.
Many patients with milder symptoms of laryngopharyngeal reflux might initially improve with diet modifications alone. This involves reducing food contents that might irritate the stomach membranes, as well as modifying the time and quantity of the foods so that the stomach never overdistends itself. Please refer to Dr. Namdar’s guidelines for reflux diet.
Additionally, acid-lowering medications might be advisable, at least initially, to further lower the production of acid. The consultation with your specialist would clarify if these medicines are necessary and if so, how long they should be used.
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