What is Laryngopharyngeal Reflux?

…An unusually common condition that can cause multiple health issues.

There are many things that upset Voice Box about reflux.  One is that it is over-diagnosed.  There are thousands of people, particularly the elderly, who are prescribed drugs for reflux, are left on them forever, and do not even know that they are taking them.  Another problem is that it is under-diagnosed…sounds paradoxical, but it seems we are often just looking in the wrong places.

There are two types of reflux currently known:

  • Gastroesophageal reflux disease (GORD)
  • Laryngopharyngeal reflux (LPR)

Sadly. many healthcare professionals still do not know about laryngopharyngeal reflux, and many people with this condition are mistakenly diagnosed with GORD.  To explain further:

  • GORD is reflux due to a problem with the function of the lower oesophageal sphincter, a band of muscle that lets food/drink into your stomach, and stops it from coming back up again.  People with this often experience heartburn and lower gastric discomfort.
  • LPR is a problem with the upper oesophageal sphincter, which lets food and drink enter the oesophagus when open and stops it from coming back up into the larynx.  This can be called ‘silent’ reflux as it often causes no discomfort.  However, people with LPR often experience laryngeal irritation and voice changes.  LPR has even been linked to some lung and respiratory conditions and glue-ear in children.  LPR is a big factor in PVCM and chronic cough.

GORD usually does not affect the larynx, and therefore is not treated at Voice Box.  However, LPR can cause major laryngeal damage.  Reflux is often diagnosed differentially, that is, by exclusion, but the best way to diagnose it is to view signs of it in the larynx, with endoscopic investigation.  Therefore clients suspected of having LPR will usually be required to have an assessment by an ENT doctor.

Treatment of LPR usually involves medical management, dietary and behavioural modifications.  Therefore cooperation by your GP is essential.  Madeleine can help you with all aspects of your LPR treatment.  If LPR has affected your voice or you have PVCM, Madeleine specialises in providing therapy for these disorders.


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