What Is Laryngopharyngeal Reflux (Silent Reflux, LPR, GERD)?

A Quick Primer on Laryngopharyngeal Reflux (LPR)

Laryngopharyngeal reflux or LPR occurs when food or stomach acids flow back up into the larynx or pharynx. This back flow can occur at ANYTIME day or night in the recumbent or erect position. Some people may experience heartburn, but many do not because the acid does not stay in the esophagus long enough to irritate or cause Silent Reflux (GERD).

The larynx and pharynx are more sensitive than the esophagus to stomach acids. Because the larynx does not tolerate any acid exposure, proton pump inhibitors must be used twice daily, with an H2-blocker at night, to effect complete acid reduction.

LPR may be associated with esophagitis, esophageal strictures or esophageal webs.

Diagnosing LPR

• Morning sore throat is frequently associated with LPR
• Laryngospasm at night is frequently associated with LPR
• Late night eating frequently worsens symptoms. Patient should be advised against eating or drinking 3-4 hours before reclining
• Avoid ingesting or combining caffeine, fatty foods, citrus fruits, citrus juices, cooked tomato products and carbonated beverages
• Get re-evaluated by your ENT doctor 2-3 months after treatment
• Some patients with severe asthma problems may be candidates for LPR
• Dual-probe 24 hour pH study may be necessary
• Severe cases may require GI endoscopy to rule out associated esophageal pathology

Symptoms of Silent Reflux (LPR)

• Voice change or hoarseness
• Onset
• Cough – timing of cough, productivity
• Heartburn – any association with food
• Dysphagia (difficulty swallowing)
• Globus sensation (foreign body sensation)
• Frequent throat clearing