Cough? Throat Clearing? Hoarseness? Phlegm in the Throat? You could have Laryngopharyngeal Reflux (LPR)

March 24th, 2010
Stomach acid in the throat is a very common problem It is caused by a problem with digestion and manifests with a constellation of symptoms. These include a wide variety of common complaints. An index score of these complaints helps us to diagnose the problem. These symptoms may come and go or wax and wane and last days, weeks, months or years. I have seen people with symptoms from this cause that have been successfully treated after 30 years of LPR!

So, do you or a loved one (of any age) have LPR?

1) Cough, particularly non-productive or with frothy mucous, may be LPR.
2) A feeling of something in the throat when nothing is there, may be LPR.
3) A wheeze on inhaling or a choking episode, particularly in the middle of the night, may be LPR
4) A sore throat or debris in the tonsils that doesn’t respond to antibiotics, may be LPR.
5) Hoarseness, particularly voice change with use or that waxes and wanes, may be LPR.
6) Nasal congestion, particularly when non-seasonal, may be LPR
7) Ear pressure, especially not related to altitude change, may be LPR.
8) Interesting for a problem that has stomach acid as its key, heartburn is not common—occurring in less than 10%

The work up includes a careful head and neck examination, a Barium Swallow and a painless in-office study to carefully look at the pharynx and voicebox called a Video Stroboscopy.

Treatment consists of medication and a change in diet. The medications most commonly used are Protein Pump Inhibitors (such as omeprazole, nexium, kapidex), or H2 blockers (such as ranitidine or famotidine). These medications, some of which are either over-the counter or generic, may need to be used for weeks to months. They are much more effective when combined with a diet that avoids or eliminates caffeine, diary products and highly processed foods such as high fructose corn syrup.

Most all of our patients get better to the point that they can get off of daily medication and most can loosen up on the dietary precautions.

Tags: cough, hoarseness, Laryngopharyngeal Reflux, LPR
Posted in: Care for Coughs | Comments Off