Laryngopharyngeal Reflux
127 Case Studies
92 Member Stories
1513 Research

LPR is the backward motion of stomach enzymes (Pepsin) and acid in the lower throat region. Consider making diet and lifestyle changes to facilitate laryngopharyngeal reflux symptoms. Several complementary remedies like Ayurveda may help as well.

What is Laryngopharyngeal Reflux?

Laryngopharyngeal reflux is a sort of gastroesophageal reflux disease (GERD). LPR is the backward motion of stomach enzymes (Pepsin) and acid in the lower throat region. Contents of the stomach can flow all the way up the esophagus, in the back of the throat, and, sometimes, in the back of the nasal passages.  LPR patients may not even be aware of  LPR. Unlike Gastroesophageal Reflux Disease (GERD) patients, they don't feel the heartburn sensation. When the throat lining is irritated by gut contents, there's the secretion of a mucus blanket in an effort to protect the liner from the caustic agents. Frequent coughing and throat clearing are typical symptoms. Individuals with laryngopharyngeal reflux might feel as though they have something stuck in their throat. Laryngopharyngeal reflux can lead to hoarseness and other voice issues, too.

Medications usually can reduce the symptoms of laryngopharyngeal reflux significantly. A class of drugs called proton pump inhibitors work by decreasing the amount of acid the stomach produces. 

Patients can manifest symptoms like excessive throat-clearing (particularly in the morning or after a meal), persistent dry cough, sore throats not associated with a cold, hoarseness, or the feeling of a lump in the throat. The natural treatment of LPR requires multiple approaches with a focus on diet and behavior changes.

The significant contributor to laryngopharyngeal reflux (LPR) is malfunctioning sphincters. Sphincters act as valves that keep food in the ideal organ of your digestive tract until it is ready to be passed. The LES is the first anti-reflux barrier that sits right above the stomach. The LES must open at precisely the right moment to digest food, but prevent any reflux the remainder of the time. For reasons not yet fully understood, the LES relaxes regularly. Those events are known as transient lower esophageal sphincter relaxations.

The lower esophageal sphincter is a muscle that gets weaker over time. It stops working as it should as a barrier against reflux. After years of overeating and poor eating habits, the reduced Esophageal sphincter can get weaker, and reflux can grow. Most individuals do not even understand that they're eating unnaturally, as pretty much everyone nowadays is doing it. We develop it. There are supplementary measures one can take to help control laryngopharyngeal reflux. Among the most significant is eating a diet that's low in acid. Research has indicated that this kind of diet often can reduce laryngopharyngeal reflux symptoms.

See: How I and My Husband Followed Natural Therapies to Help with GERD

LPR treatments with diet

How to heal a malfunctioning LES with diet

There are many diet treatment options. You should consider making diet and lifestyle changes to facilitate the laryngopharyngeal reflux symptoms. Several complementary remedies may help, also.

Eating smaller meals makes a positive impact. That will put less strain on your LES. Even more important is to stop late-night eating. Eating in an upright position helps, and use gravity to your advantage. If you lie down, the contents of your stomach are pressing the LES. In addition to that, digestion is slower when you sleep. When most individuals with LPR reflux throughout the daytime, the worst cases are because of nighttime reflux. All of your anti-reflux defenses are non-existent, which may explain why reflux causes more harm.

Some foods impair the function of the reduced esophageal sphincter. Foods that trigger sphincters include caffeine, alcohol, and chocolate. Others that can create gas that presses open the sphincter include onions. 


See: Heartburn and Acid Reflux Remedies

Silent reflux diet changes

Diet Changes

Various foods affect LPR through distinct mechanisms. These particular foods should be avoided or reduced significantly, or they will interfere with the healing process. These foods include alcohol, chocolates, caffeine, and peppermints. They weaken the lower esophageal sphincter, which usually holds from the gut contents. Citrus fruits, tomatoes, kiwi, pineapples, (and other acidic foods), hot deli meats, and hot spices (spicy mustard, curry, hot peppers) directly irritate the throat lining. It follows that even if the medications are working well, eating these foods will cause direct irritation and inflammation of the throat lining. Carbonated beverages such as beer and sodas bring acidic contents into the throat. Examples of low-acid foods are melons, green leafy vegetables, celery, and bananas.

Foods that individuals with laryngopharyngeal reflux should avoid include hot, fatty and fried foods; citrus fruits; berries; chocolate; peppermint; cheese; and garlic. Foods that contain caffeine, carbonated drinks, and alcohol can also worsen symptoms.


See: Ginger for acid reflux relief

Lifestyle behavior changes

Behavior Changes

- Don't increase the pressure within the abdomen for at least 2 hours after eating (no bending over, exercising, or singing), since it will force contents into the throat.

- Eat smaller meals during the day, rather than three larger meals.

- Don't lie down within 3 hours after eating a meal.

- Don't eat a snack or beverage before going to sleep. The head of your bed should be propped up by 4-6 inches to permit gravity to help keep contents in your stomach.

See: GERD Cough Natural Treatment

How to cure your silent reflux

Don't Overeat

While following these proposed diet measures is crucial to recouping from LPR, there are other components which should also be followed. Among the main things to think about is the size of the parts you're eating. 

The reason you don't wish to eat huge portions is due to the strain it places on the lower esophageal sphincter (LES). The LES is the valve over the stomach that's intended to shut once foods enter the stomach, and then the digestion procedure starts. When someone eats a larger sized meal, it puts more pressure on the LES. The higher pressure means a greater chance that the LES will relax and open. Consequently, the acid will reflux up, causing you your symptoms, to begin with. Overeating may cause the LES to gradually degrade and degenerate over time. This might be over a period of months or even years for many people. The easy solution in this scenario is to eat smaller portion sizes. You should not consume more than what your stomach can hold at the same time. The size of your fist is a reasonable estimate of how much that is. Bear in mind this does not mean to eat less during the day, but it means to spread it out evenly between more snacks and meals rather than fewer larger meals. Years of overeating can be slowly healed over time, and LPR may be a distant memory.

It helps to consume the most substantial meal of the day at midday or in the morning, and also to avoid eating within three hours of bedtime. Do not rush through meals. Take time to eat slowly, without distractions.

See: Soothe Your Acid Reflux And Prevent GERD With This Yoga Series

Complementary therapies for LPR

Complementary therapies

Several complementary remedies also may be useful in handling laryngopharyngeal reflux. As an example, some studies indicate that acupuncture - a treatment that involves inserting extremely thin needles through the skin in strategic points within the body - may reduce symptoms. 

Ayurveda is also a centuries-old holistic medicine practice with diet and lifestyle remedies that address reflux at the root cause and reduce symptoms.

Taking a probiotic dietary supplement that contains the good bacteria may alleviate some symptoms, also. But they are not for everybody, and various supplements contain different kinds of probiotics. Before you choose a probiotic, you should ask your healthcare provider concerning the type and amount that is perfect for you.

Ultimately, voice therapy may be used to treat the effects of laryngopharyngeal reflux. Research has proven that individuals who take a proton pump inhibitor and take part in voice therapy show quicker symptom improvement than people who take drugs.

Your health care provider can discuss additional treatment options and lifestyle changes for your persistent laryngopharyngeal reflux symptoms. There are many potential causes for LPR and lots of possible solutions. Often times, laryngopharyngeal reflux may be managed successfully with natural therapies. Other lifestyle changes that can help someone with laryngopharyngeal reflux include maintaining a healthy weight, not smoking, and reducing and managing stress in healthy ways.


See: Acupuncture And Traditional Chinese Medicine helps with GERD and Digestion Problems

Differences between LPR vs. GERD

LPR Characteristics

Laryngopharyngeal reflux (LPR) results from chronic acid and pepsin flow and exposure to the larynx. Frequent LPR symptoms include

 • Hoarseness 

• Voice problems 

• Thick or too much mucus 

• Persistent throat irritation 

• Persistent throat-clearing 

• Persistent cough 

Differences between LPR vs. GERD

Gastroesophageal reflux disease (GERD) occurs when stomach acid and enzymes backflow to the esophagus, causing heartburn (burning sensation in the chest) and damage to the esophageal lining. LPR occurs when stomach acid or food enzymes backflow all of the way back to the lower portion of the throat (laryngopharynx). Not everybody who has reflux has LPR.

LPR without GERD

Lots of people with LPR don't have symptoms of heartburn. In comparison to the esophagus, the voice box and the back of the throat are more sensitive to the effects of acid and pepsin on the surrounding cells. The acid that moves quickly through the food pipe doesn't have an opportunity to irritate the area for a long time. However, the acid which pools in the throat around the voice box causes prolonged irritation, leading to the symptoms of LPR.

See: Successful Case of Ayurveda Treatment for GERD

Holistic treatments for silent reflux

Drink Water to Promote Digestion

Aim to drink the vast majority of your fluids between meals, rather than with your meal. This will help to keep the quantity on your stomach down at mealtimes. You might also try avoiding carbonated drinks. The bubbles in carbonated beverages may result in burping, which provides opportunities for acid to reflux into the food pipe.

Practice Stress Reduction

Although it's not known precisely how stress exacerbates acid reflux, it has been demonstrated that both are undeniably linked. Identify the causes of anxiety in your life and brainstorm sustainable coping strategies. Ideas may include:

- Meditation

- Deep breathing

- Massage

- Spending time outdoors in nature

- Exercising

Throat-clearing alternatives

- If you feel a build-up of secretions from the throat, try swallowing a sip of water. You can also try a "silent cough" by shoving as much air as possible from the lungs at a brief blast. 

- Dietary changes can make a significant impact on silent reflux. Because acidic foods and beverages can activate pepsin in their way into the gut, preventing them improves symptoms.

- Medications that reduce acid production in the stomach, known as proton-pump inhibitors (PPIs), are often prescribed for silent reflux. These medications can decrease heartburn, but they do work well for airway symptoms like a sore throat. The reason is that the harm isn't just due to acid alone but in conjunction with the gut enzyme pepsin. Acid suppressing medication doesn't affect pepsin.

See: Acid Reflux Diet for GERD

Risks

Stomach acid that pools in the throat and larynx (voice box) can cause long-term irritation and damage, and without treatment, it may lead to serious issues. In adults, silent reflux can scar the throat and voice box and increase the risk of cancer in the region. The lungs may also be affected, and it can aggravate current conditions like bronchitis, asthma, or emphysema. Consult a doctor and seek medical attention.


See: Acid reflux in the morning remedies

References

1. Kahrilas, P. J. (2018, January 31). Complications of gastroesophageal reflux in adults. https://www.uptodate.com/contents/complications-of-gastroesophageal-reflux-in-adults?search=complications-of-gastroesophageal-reflux-in-adults%EF%BB%BF&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

2. Laryngopharyngeal reflux. (2012, April 16) https://my.clevelandclinic.org/health/diseases/15024-laryngopharyngeal-reflux-lpr

3. Mayo Clinic Staff. (2015, November 18). Infant reflux: Symptoms and causes http://www.mayoclinic.org/diseases-conditions/infant-acid-reflux/symptoms-causes/dxc-20157641

4. Waring, J. P. (2016, February 10). Laryngeal pharyngeal reflux http://www.aboutgerd.org/laryngeal-pharyngeal-reflux.html

5. Worried your sore throat may be strep? (2018, January 31) https://www.cdc.gov/features/strepthroat/index.html

6. Ahuja, V., Yencha, M. W., & Lassen, L. F. (1999, September 1). Head and neck manifestations of gastroesophageal reflux disease. American Family Physician, 60(3), 873-880 http://www.aafp.org/afp/1999/0901/p873.html

7. Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope. 1991;101(S53):1-78.

8. Laryngopharyngeal Reflux (LPR). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/15024-laryngopharyngeal-reflux-lpr. 

9. Koufman JA. Low-acid diet for recalcitrant laryngopharyngeal reflux: Therapeutic benefits and their implications. Ann Otol Rhinol Laryngol. 2011;120(5):281-7.

10. Cochran, W. J. (2017, February). Gastroesophageal reflux in infants. Merck Manuals

https://www.msdmanuals.com/en-gb/professional/pediatrics/gastrointestinal-disorders-in-neonates-and-infants/gastroesophageal-reflux-in-infants

11. Diphtheria symptoms. (2016, January 15) https://www.cdc.gov/diphtheria/about/symptoms.html

See: Acid Reflux Foods To Avoid

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