Acid reflux is often associated with heartburn, a burning chest sensation linked to gastroesophageal reflux disease (GERD). However, another form of acid reflux, called laryngopharyngeal reflux (LPR), differs in symptoms and the areas it affects. Knowing how GERD and LPR differ can help in managing symptoms more effectively and seeking the appropriate treatment.
GERD vs. laryngopharyngeal reflux
Both GERD and LPR are forms of acid reflux, but they impact different areas:
- GERD (Gastroesophageal Reflux Disease): In GERD, stomach acid flows back into the esophagus, the tube that connects the throat to the stomach. This often results in the typical burning sensation known as heartburn.
- LPR (Laryngopharyngeal Reflux): With LPR, stomach acid travels even further up, reaching the throat and voice box. This condition is sometimes known as “silent reflux” because it often lacks the usual GERD symptom of heartburn.
Signs: how GERD and LPR show up differently
GERD and LPR symptoms often differ because of the areas affected.
Signs of GERD
- Heartburn
- Chest pain
- Regurgitation of food or sour liquid
- Difficulty swallowing
These symptoms tend to worsen after meals or when lying down.
Signs of LPR
- Hoarseness
- Persistent cough
- Feeling of a lump in the throat (globus sensation)
- Frequent throat clearing
- Sore throat
Since LPR affects the throat and voice box, it’s common for patients to experience symptoms in their voice and throat without heartburn, making LPR more challenging to recognize.
What causes LPR?
With LPR, acid reaches higher into the throat and voice box due to factors like:
- Upper Esophageal Sphincter Weakness: In LPR, the upper esophageal sphincter may not work as effectively, allowing acid to reach the throat.
- Diet and Lifestyle: Spicy or fatty foods, overeating, and certain lifestyle habits like smoking can trigger both GERD and LPR. Additionally, stress or excessive voice use can make LPR symptoms worse.
Why LPR is “silent” and often missed
Unlike GERD, which has a clearer connection to heartburn, LPR’s symptoms can be more subtle. Because the acid affects the throat and voice box, it often results in symptoms like throat irritation, hoarseness, and a cough rather than chest pain. As a result, it’s easy to overlook or mistake LPR symptoms for other respiratory or voice issues.
Diagnosing LPR vs. GERD
An ENT specialist may use a few tests to determine if symptoms are due to GERD or LPR:
- Endoscopy or Laryngoscopy: These procedures allow doctors to view the throat and esophagus to check for signs of acid damage.
- Dual pH Probe Test: This measures acid levels in both the esophagus and throat, helping differentiate between GERD and LPR.
Why it’s important to distinguish LPR from GERD
Accurately identifying LPR versus GERD is key to effective treatment. While GERD treatments focus on managing acid and diet, LPR often requires more attention to vocal health and other lifestyle adjustments. Treating the correct condition can help avoid unnecessary complications and allow for a tailored plan that targets specific symptoms.
Complications of untreated LPR
- Chronic Throat Irritation: Persistent acid exposure can damage throat tissues.
- Vocal Cord Damage: Acid can lead to inflammation or ulcers on the vocal cords, affecting voice quality.
- Aspiration Pneumonia: In some cases, stomach acid entering the lungs can cause respiratory issues.
If throat or voice symptoms persist, especially without typical heartburn, consult an ENT specialist to determine if it could be LPR and start on the most effective path to relief.
Treatment options for LPR
While treatment for GERD and LPR can overlap, LPR often needs additional care to address throat and voice issues.
- Dietary Adjustments: Avoiding acidic, spicy, or fatty foods can help reduce symptoms.
- Lifestyle Changes: Avoiding lying down after meals, losing weight, and reducing stress are common recommendations.
- Medications: Acid-reducing medications like proton pump inhibitors (PPIs) or H2 blockers may be prescribed, though they often work best when combined with dietary and lifestyle changes.
- Voice Rest and Care: Patients with LPR may also need to reduce voice strain and get plenty of vocal rest to help reduce throat irritation.
Seeking help for persistent throat symptoms
If you’re experiencing symptoms like hoarseness, frequent throat clearing, or chronic cough without the burning sensation of heartburn, consult an ENT specialist in your area.
An ENT can help identify LPR, create an effective treatment plan, and offer recommendations tailored to your specific symptoms.