LARYNGOPHARYNGEAL REFLUX (Adult and Pediatric)
Gastroesophageal reflux (GERD) is a condition in which stomach acid refluxes from the stomach back into the esophagus. This can cause patients to have heartburn, otherwise known as acid indigestion. When acid reflux is particularly severe, the acid can reach all the way up into the throat. In this case, it is referred to as laryngopharyngeal reflux (LPR).
Stomach contents are quite acidic for the purposes of digesting food, but when refluxed up into the esophagus or throat, this acid can be very irritating to the tissues. Adult patients and older children may complain of a sore throat, hoarseness, difficulty swallowing, excessive phlegm, chronic throat clearing, post nasal drip, the sensation of a lump in the throat (globus pharyngeus), and even sinus and ear problems. Of note, patients with LPR may not have any signs of heartburn, a condition called silent reflux, and this can sometimes lead to a delay in diagnosis.
Infants and young children may also suffer from GERD and LPR, but due to their young age, are not able to voice their complaints. Symptoms of pediatric reflux include: mild laryngitis or hoarseness, frequent regurgitation with esophagitis manifested as irritability or back arching, failure to thrive, respiratory symptoms like congestion and cough, noisy breathing, or even life-threatening events associated with choking, gagging, or turning blue.
Treatment of laryngopharyngeal reflux is aimed at decreasing acid production. One way to accomplish this is by avoiding foods know to stimulate the stomach to produce acid. Some examples include tomatoes, spicy foods, fatty or fried foods, caffeine, alcohol, nicotine, mints, and chocolate. Patients are usually prescribed an acid blocking medication as well. In addition to diet modification, patients may be instructed to elevate the head of bed to prevent acid reflux at night, and are advised to avoid food within two to three hours of bedtime. LPR is a reversible process, but it can take weeks to months of therapy before the symptoms resolve. Reflux is often treated by an Ear, Nose, and Throat specialist in conjunction with a gastroenterologist.