How common is laryngopharyngeal reflux? How to get rid of laryngopharyngeal reflux? Let’s find out about laryngopharyngeal reflux diagnosis and treatment!
Table of Contents
Laryngopharyngeal Reflux Meaning
Laryngopharyngeal reflux definition. What is laryngopharyngeal reflux? Laryngopharyngeal reflux is when acid from the stomach goes up the esophagus (the tube you use to swallow) and into the throat.
Laryngopharyngeal Reflux Causes
What causes laryngopharyngeal reflux? Laryngopharyngeal reflux is thought to cause chronic hoarseness when other causes of abnormal vocal fold vibration (like a tumor or nodules) have been ruled out by a laryngoscopy.
Gastroesophageal reflux disease (GERD) has also been linked to other symptoms, such as clearing the throat, throat pain, a persistent cough, a feeling of postnasal drip, esophageal spasm, and some cases of asthma.
Since less than half of people exposed to laryngeal acid have typical symptoms like heartburn and regurgitation, the lack of these symptoms should not be taken as proof that this is not the cause. Most people with laryngopharyngeal reflux, or symptomatic laryngopharyngeal reflux, as it is now called, do not meet the criteria for GERD when tested with a PH probe, so these two conditions need to be looked at separately. There are many different opinions about this condition, and it may not be as common as was once thought.
Laryngopharyngeal Reflux Diagnosis
Laryngopharyngeal Reflux Symptoms
Signs and symptoms of laryngopharyngeal reflux
- Most often causes hoarseness, throat irritation, and a persistent cough.
- Most symptoms happen when a person stands up, and half of the patients don’t have heartburn.
- To rule out other causes of hoarseness, laryngoscopy is a must.
- The treatment with proton pump inhibitors is used to make the diagnosis.
- Proton-pump inhibitors don’t always work, which suggests that there are other causes.
Laryngopharyngeal Reflux Treatment and Management
Treatment of laryngopharyngeal reflux – What is laryngopharyngeal reflux medication? What is the best treatment for laryngopharyngeal reflux?
Laryngoscopy should be used to rule out other causes of dysphonia as the first step in the evaluation process. An otolaryngologist should also be consulted.
Since there is no gold standard for diagnosing this condition, many doctors choose to try a proton-pump inhibitor on a patient to see if it works. However, such an empirical test shouldn’t come before seeing the vocal folds to rule out other causes of hoarseness.
When used, the American Academy of Otolaryngology-Head and Neck Surgery recommends therapy with a full-strength proton-pump inhibitor (e.g., omeprazole 40 mg orally twice daily, or an equivalent) for at least 3 months. Patients may notice an improvement in their symptoms after 3 months, but the changes in the larynx usually take 6 months to go away.
If symptoms get better and stopping therapy makes them return, a proton-pump inhibitor is given again at the lowest effective dose for remission, usually daily but sometimes only when needed. Even though H-receptor antagonists are an alternative to proton-pump inhibitors, they are usually less effective and cost-effective.
Nonresponders should get pH tests and manometry. Twenty-four-hour pH monitoring of the pharynx is the best way to document laryngopharyngeal reflux and is recommended by some as the first step in treatment. However, it is more expensive, harder to do, and less available than lower esophageal monitoring alone.
Testing with a double pH probe (proximal and distal esophageal probes) is the best to evaluate since lower esophageal pH monitoring alone does not correlate well with laryngopharyngeal reflux symptoms. Oropharyngeal pH probe testing is available, but it is not known if it can predict how patients with laryngopharyngeal reflux will respond to treatment.
I hope you understand laryngopharyngeal reflux diagnosis and treatment guidelines.