Alicia Ault, a freelance writer in St. Petersburg, Fla., was once puzzled by her hoarse voice, middle-of-the-night cough, and difficulty swallowing. However, after watching a video about laryngopharyngeal reflux (LPR) while waiting to see an ear, nose, and throat doctor, everything fell into place. The video listed the symptoms of LPR, which aligned perfectly with what Ault was experiencing. She had never heard of LPR before, believing instead that her problems were caused by asthma or sinusitis. However, after seeing the video, Ault suspected that LPR was the underlying issue, a suspicion that was confirmed by the ENT staff.
LPR, also known as “silent reflux,” is often undiagnosed as it doesn’t always display the typical symptoms of gastroesophageal reflux disease (GERD). The condition can cause hoarseness, coughing, a burning sensation and mucous in the throat, difficulty swallowing, vocal cord spasms, and a bad taste in the mouth upon awakening. While GERD is well-known, LPR is less familiar to the general public, affecting an estimated 10 percent of people who seek help from a throat specialist.
In people with LPR, acid and digestive enzymes flow back into the larynx and pharynx through the esophagus, as opposed to GERD where stomach contents travel to the lower esophagus. GERD symptoms often include heartburn, indigestion, and upper abdominal or chest pain. While the symptoms of GERD and LPR can overlap, they are not always the same. Treatment for both conditions involves acid-blockers, a low-acid diet, and lifestyle changes.
Research has found a link between LPR and asthma, pneumonia, and bronchiectasis, which causes widening and looseness of the air-carrying tubes in the lungs. LPR can also have a detrimental effect on the voice, leading to hoarseness and frequent throat-clearing. In severe cases, laryngospasm, where a drop of acid enters the throat and causes it to close up, can occur. This symptom can be terrifying and may cause patients to panic. However, with the help of behavior modification, diet changes, and medication, LPR symptoms can be managed, usually within a few months.
Diagnosing LPR can be challenging as its symptoms can mimic other diseases. Gastroenterologists and ear, nose, and throat specialists typically diagnose LPR based on symptoms, with laryngoscopies occasionally used to rule out other conditions. While there are tests available, such as oral salivary pepsin testing and pH monitoring, the medical community is still searching for reliable diagnostic tools.
Some individuals with LPR have found relief through lifestyle changes and natural remedies. For example, Alicia Ault followed a strict low-acid diet, took prescribed medications, and rinsed her nasal passages with a mild steroid and saline solution. These changes significantly reduced her reflux symptoms. Megha Ramani, another LPR sufferer, made similar lifestyle changes, consulting an Ayurvedic doctor, modifying her diet, practicing yoga and Pilates, and undergoing speech therapy.
Overall, managing LPR requires a combination of medication, diet adjustments, exercise, weight loss, and other lifestyle modifications. It may also involve using special pillows or elevating the head of the bed to alleviate symptoms. Quitting smoking, limiting alcohol consumption, and avoiding eating right before bedtime are also recommended. Taking Gaviscon or alginates from brown seaweed, and sometimes muscle relaxants like Baclofen, may provide relief in certain cases. Ultimately, finding ways to manage LPR is worth the effort, even if it means making some sacrifices.
