Laryngopharyngeal Reflux (LPR) defines the process during gastroesophageal reflux where stomach contents pass through the esophagus, upper esophageal sphincter, and into the back of the throat. LPR can cause swelling of the vocal cords through direct contact by acid and digestive enzymes, or may cause a secondary effect on the voice by irritating the throat and swallowing muscles.
Symptoms of LPR classically occur in the throat rather than the chest, compared to gastroesophageal reflux disease gastroesophageal reflux disease GERD, with common symptoms being:
- chronic cough
- lump in throat sensation
- persistent throat clearing
- mild sore throat
- raspy voice
- a plegmy throat
- but can include heartburn
- chest pain
- difficulty swallowing
- regurgitation of food or sour liquid
- Singers may experience vocal fatigue or loss of range, or feel discomfort with vocalization.
Diagnosing LPR can be tricky because many of its symptoms overlap with other throat disorders. It is important to be evaluated by a laryngologist with special expertise in voice care. A careful ear, nose, and throat exam will be conducted to check for sign of LPR, as well as other conditions that could cause similar symptoms. LPR can most often be treated through diet and lifestyle changes, such as limiting certain food groups, altering the eating schedule, introducing natural antacid supplements, and quitting smoking or vaping. In some cases, weight loss may relieve the symptoms of LPR. In more rare cases, medication and diagnostic testing for anatomic issues such as hiatal hernia or motility problems may be necessary. It is important to consult a trained laryngologist to learn what is the right treatment path for you.