Laryngopharyngeal Reflux

Laryngopharyngeal reflux is defined as injury to the throat (pharynx) or voice box (larynx) or symptoms caused by flow of stomach contents back up into the throat.

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Symptoms

Patients with the condition may or may not have typical symptoms of GERD, including:

  • Change in the voice
  • Weak voice
  • Cracking voice
  • Continual throat clearing
  • Excessive phlegm
  • Postnasal drip
  • Cough
  • Dysphagia (difficulty swallowing)
  • Constant sensation of something in the throat
  • Heartburn
  • Swallowed food that comes back up
  • Blockage of the breathing passage
  • Spasm of the larynx (voice box)
  • Wheezing
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Diagnosis

Diagnosing laryngopharyngeal reflux can be difficult because it is frequently not associated with typical symptoms of gastroesophageal reflux disease. To confirm the condition, the doctor may do the following tests:

  • Laryngoscopy is used to see changes of the throat and voice box.
  • 24-hour pH testing is used to see if too much stomach acid is moving into the upper esophagus or throat. Two pH sensors (one at the bottom of the esophagus and one at the top) allows the doctor see if acid moves back to the top of the esophagus.
  • Upper GI endoscopy is almost always used if a patient complains of dysphagia. The test is done to identify and biopsy scar or abnormal growths in the esophagus. It can also show inflammation of the esophagus caused by gastroesophageal reflux.
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Treatments

Laryngopharyngeal reflux can be managed effectively with proper treatment. Lifestyle modifications that may be prescribed include:

  • Elevation of the head of the bed four to six inches
  • Avoiding alcohol, chocolate and caffeine
  • Avoiding overeating
  • Eating or drinking nothing two to three hours before bed
  • Avoiding greasy, fatty foods
  • Losing weight

Medical treatments may include one or a combination of the following:

  • Antacids to neutralize excess stomach acid
  • Anti-secretory medications that decrease acid production by the stomach
  • Surgery to tighten the junction between the stomach and esophagus. The most commonly performed surgery is called the Nissen Fundoplication. It is done by wrapping the top part of the stomach around the junction between the stomach and esophagus and sewing it in place.