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laryngopharyngeal reflux (LPR)

Etiology: - complication of GERD Clinical manifestations: 1) hoarseness 2) repetitive throat clearing 3) excessive pharyngeal mucous 4) globus 5) voice changes 6) duration > 3 months Special laboratory: - laryngoscopy - 24 hour esophageal pH monitor (ambulatory) Differential diagnosis: - GERD Management: 1) proton pump inhibitor (PPI) of no benefit [1] 2) acid suppression likely to prevent laryngopharyngeal injury with GERD-associated laryngopharyngeal reflux [2] 3) alkaline water (pH >8.0) & a plant-based, Mediterranean diet plus standard reflux precautions no better than PPI [4]

Related

gastroesophageal reflux disease (GERD) laryngitis larynx pharynx

General

laryngeal disease reflux

References

  1. Vaezi MF et al, Treatment of chronic posterior laryngitis with esomeprazole Laryngoscope 2006;116:254 PMID: 16467715
  2. Roh JL, Lee YW, Park HT. Effect of acid, pepsin, and bile acid on the stenotic progression of traumatized subglottis. Am J Gastroenterol. 2006 Jun;101(6):1186-92. PMID: 16771935
  3. Wo JM et al, Double-blind, placebo-controlled trial with single-dose pantoprozole for laryngopharyngeal reflux. Am J Gastroenterol 2006, 101:1972 PMID: 16968502 - Vaezi MF et al, Treatment of chronic posterior laryngitis with esomeprazole. Laryngoscope 2006, 116:254 PMID: 16467715
  4. Zalvan CH, Hu S, Greenberg B et al A Comparison of Alkaline Water and Mediterranean Diet vs Proton Pump Inhibition for Treatment of Laryngopharyngeal Reflux. JAMA Otolaryngol Head Neck Surg. Published online Sept 7, 2017 PMID: 28880991 http://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2652893 - Kavitt RT Dietary Modifications in the Treatment of Laryngopharyngeal Reflux - WIll "an Apple a Day" Keep the Laryngopharyngeal Reflux Away? JAMA Otolaryngol Head Neck Surg. Published online Sept 7, 2017 PMID: 28880985 http://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2652892