Acid reflux and GERD are common digestive problems. Besides GERD, acid reflux can also occur as laryngopharyngeal reflux (LPR), which happens when stomach acid travels up into the throat and causes a burning sensation.

Although they may seem alike at first, GERD and LPR have different symptom patterns. This article explains LPR symptoms and how doctors manage them.

What is Laryngopharyngeal Reflux (LPR)?

Laryngopharyngeal reflux (LPR) is a specific type of acid reflux. Acid reflux occurs when stomach acid moves from the stomach into the esophagus. In LPR, the acid rises even higher, reaching the larynx (voice box) and pharynx (upper throat).

Symptoms of LPR can include:

• Hoarseness

• Inflamed vocal cords or loss of voice

• A sensation that something is stuck in the throat

• A scratchy or uncomfortable throat

• Chronic cough

• Excess mucus or phlegm

• Difficulty swallowing

• Chronic sore throat

• Recurrent upper respiratory tract infections

• New or worsening asthma

LPR is also called extraesophageal reflux, because stomach acid travels through the esophagus and irritates throat structures. This produces symptoms that differ from typical GERD.

While GERD most often causes digestive symptoms such as heartburn, LPR more commonly causes voice and throat complaints. Because the symptoms do not always feel like “acid reflux,” the condition is often referred to as silent reflux.

How is Laryngopharyngeal Reflux (LPR) Different from GERD?

GERD and LPR are both considered as acid reflux, but their symptoms differ. GERD is generally marked by heartburn, whereas LPR often lacks classic signs and can resemble a cold or allergies. This makes LPR harder to recognize and diagnose.

Both can cause difficulty swallowing (dysphagia), but the location differs. In GERD, difficulty swallowing is usually felt lower in the throat or chest and may come with a sensation of food getting stuck. In LPR, difficulty appears earlier, right after you swallow.

What Causes Laryngopharyngeal Reflux (LPR)?

Two protective valves, or esophageal sphincters, help prevent backflow of stomach contents. The upper esophageal sphincter separates the esophagus from the throat, and the lower esophageal sphincter separates the esophagus from the stomach.

Acid reflux develops if the lower esophageal sphincter weakens, allowing stomach contents to move back into the esophagus. LPR occurs if the upper esophageal sphincter does not close properly, so acid that has already risen can travel farther up into the throat.

Factors that can contribute to this include:

• Use of medicines that relax sphincter muscles, such as certain antidepressants, asthma medicines, and sedatives
• Foods and beverages such as coffee, alcohol, and mints
• Sleeping on your stomach
• Lying down right after eating
• Eating large portions of meals
• Smoking
• Pregnancy

How is Laryngopharyngeal Reflux (LPR) Treated?

Treatment depends on the severity and underlying cause. In mild cases, adjustments to eating patterns and lifestyle are usually enough to reduce reflux symptoms. In other situations, additional medical care is needed.

Management for LPR includes:

• Medications: These help neutralize stomach acid and protect throat tissues during healing. If antacids are not sufficient, your doctor may prescribe acid-suppressing medicines or add agents that help protect the throat lining from irritation.

• Surgical procedures: Surgery is uncommon unless there is a clear problem affecting sphincter function, such as a hiatal hernia. In selected cases, doctors may perform an operation to strengthen the upper esophageal sphincter to prevent recurring reflux.

Laryngopharyngeal reflux (LPR) often lacks distinctive symptoms, which makes it harder to detect. If you notice signs that suggest LPR, consult a doctor promptly. You can also use the consultation feature in the Ai Care app, available on the App Store and Play Store.

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