LPR (Laryngopharyngeal Reflux) is a form of GERD (Gastroesophageal Reflux) characterized by reflux of stomach acid up through the esophagus into the throat. It is associated with a variety of symptoms including: compulsive throat clearing, hoarseness, difficulty swallowing, chronic cough, a feeling that “something is stuck” in the throat (globus) and “post nasal drip”.
Many people with LPR do not experience the characteristic symptoms of GERD such as indigestion and heartburn. In infants and children, LPR may cause cough, hoarseness, noisy breathing (Stridor), croup, asthma, sleep disordered breathing, spitting up while feeding, breathing difficulty (even occasionally turning blue), apnea (breathing pauses that can be life threatening), and possible growth retardation.
Appropriate treatment of LPR, particularly in infants and children, is critically important. For proper diagnosis and treatment, an Otolaryngologist, such as Dr. Pratt at Woodstock Ear, Nose and Throat, should be consulted.
Who can be afflicted with LPR?
Men, women, infants and children can suffer with LPR. Causes can be physical or lifestyle related. Physical causes include hiatal hernia, abnormal lower or upper esophageal muscle sphincter function, uncoordinated esophageal muscles and delayed stomach emptying. Lifestyle causes include diet (chocolate, citrus fruits, fatty foods, spices and sodas), habits (tobacco products, alcoholic beverages and overeating) and even pregnancy.
Infants and children may have esophageal muscle sphincters that have yet to mature. Some people are more susceptible to LPR symptoms than others. LPR and GERD can be overlooked in infants and children, leading to chronic cough, repeated vomiting, sore throat, ear infections or middle ear fluid and airway or breathing difficulty.
Most infants outgrow their reflux problems by their first year of life, however, persistent problems may develop if LPR is left untreated.
How is LPR treated?
Most people respond well to a combination of lifestyle changes and medication. The most effective medications are called proton pump inhibitors which are designed to decrease the acid concentration of stomach fluid and promote good mucous membrane healing in the throat. Antacids, antihistamines and esophageal mobility medications are also used occasionally. Lifestyle interventions usually involve dietary modifications.
What are some dietary changes recommended in the treatment of LPR?
- Avoid eating and drinking within three hours of bedtime
- Avoid alcohol consumption
- Eat small meals slowly
- Weight reduction
- Avoid the use of tobacco products
- Wear loose fitting clothes
- Limit intake of problem foods-
- Caffeinated beverages
- Carbonated drinks
- Citrus fruits
- Fried and fatty foods