Laryngopharyngeal Reflux Disease (LPR)

Symptoms

Symptoms of LPR can include: a choking sensation, sometimes severe enough to wake a person up at night; sore throat; voice changes; a sensation of something caught in the throat; frequent coughing and throat clearing; and a sour or bitter taste in the mouth, especially upon rising in the morning. This condition can create habits that further contribute to the voice problem, such as constant throat-clearing or using excessive muscle tension when speaking.

Diagnosis

Diagnosis of reflux is generally based on the patient’s symptoms and an examination of the throat. If it’s not clear what is causing the voice problems, physicians might do a PH probe study to determine the amount of reflux coming up into the throat over a 24-hour period.

Treatment

LPR is treated primarily in two ways. Making some simple lifestyle or behavioral changes can help prevent or decrease LPR and improve the voice. In severe cases, a patient may be a candidate for a nissen fundoplication—a surgical procedure that puts a barrier between the stomach and the esophagus by tightening up the top of the stomach.

Prognosis

The Prognosis for LPR is excellent. In many instances, it can take two months of regular medication use before the LPR symptoms are significantly reduced. If there is no improvement after two months of medication, the diagnosis should be reevaluated. Eventually, most patients will be able to stop taking the medication.