Laryngopharyngeal reflux(LPR), otherwise known as silent reflux, is a form of acid reflux.
Theesophagus(food tube) has special rings of muscle (sphincters) at the top and the bottom.
Treatment usually involves acid-reducing medications as well as lifestyle and dietary changes.
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There will also be a physical exam, usually by looking inside the throat in the office.
The throat exam might show inflammation or other damage to the tissues.
This may be enough information to diagnose LPR and start treatment to see if symptoms improve.
While the person takes sips of water, their throat muscles move it down into the throat.
The catheter is worn for 24 hours while a monitor records measurements.
This test records the acid levels in the throat to look for problems with reflux.
Esophageal manometry: This test determines how well the esophagus muscles are working.
A tube passes through the mouth and into the esophagus and stomach.
The tube measures pressure in the esophagus while the person swallows water.
It can help diagnose LPR or other swallowing problems.
Transnasal esophagoscopy:This test might work as an alternative to endoscopy.
It is also taken in the office and can be done quickly (in 10 minutes or so).
A thin tube with a light and a camera passes through the nose and down into the esophagus.
It usually happens under anesthetic.
It can see any problems like inflammation or other abnormalities.
This test is more likely to happen when symptoms continue despite other treatments.
The upper esophageal sphincter may also become weakened, allowing acid to rise into the throat.
However, multiple research studies mention it in passing because stress may influence LPR.
The symptoms of LPR itself could lead to stress and anxiety.
GERD has been increasingly connected to anxiety disorders, which may lead to the development of more treatments.
Prescribed Medication
Treatment or management options are available after a diagnosis or a suspected diagnosis of LPR.
A trial of medication might be taken to see if it helps symptoms.
Some healthcare providers may also add other types ofantacids.
The PPI might be tried for about three months to see if the symptoms change.
Managing Silent Reflux During Treatment
Medications aren’t the only methods for managing LPR.
People who smoke should pursue a plan to quit.
Food and Eating Habits
Dietis another major part of treating LPR.
Reducing foods that may lead to weakening the esophageal sphincters and thereby causing symptoms is another part of management.
This diet includes a focus on plant protein, cooked vegetables, and low levels of animal fats.
For Better Sleep
In general, LPR is not a condition that affects people at night.
However, LPR may relate togastroesophageal reflux disease (GERD), which can occur at the same time.
If nighttime heartburn is one of the symptoms, makingchanges to lifestyleis another likely recommendation.
The American College of Gastroenterology recommends sleeping on a wedge pillow to raise the head.
Some people also put risers under the legs of their bed’s head.
This helps keep acid down in the stomach through gravity, preventing it from coming up into the esophagus.
Avoiding eating within two to three hours of going to bed is also advisable.
Soothing Fussy Babies
LPR is a condition that can also affect babies.
Caregivers should feed babies with LPR symptoms smaller and more frequent meals.
Keeping babies in a vertical position after eating (more upright) is another possible suggestion.
Complications
Long-term LPR can lead to certain complications, although this is not common.
Treatment can reverse some complications, although oral problems and scarring might last for a long time.
Surgery might be considered when treatments with diet, lifestyle, and medications don’t work.
Half of all people with LPR don’t usually need to take medication for the long term.
Summary
LPR is a condition that may be challenging to diagnose.
The symptoms are not specific and overlap with those of many other conditions, including GERD.
Only in recent years have guidelines for diagnosis and treatment been published to help manage LPR.
Complications and chronic LPR are uncommon but possible, and some are irreversible.
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