UR Medicine / Otolaryngology (ENT) / Speech Pathology / Our Services / LPRD

Laryngopharyngeal Reflux Disease (LPRD)

What is laryngopharyngeal reflux disease?

Laryngopharyngeal Reflux (LPR or Silent Reflux) is when the acid/pepsin backflow reaches the throat. The structures of the throat (pharynx, larynx) are more sensitive to stomach acid and pepsin so there is increased risk of damage. People with LPR often do not experience heartburn. The more common symptoms of LPR include:

Hoarseness
Frequent laryngitis
Throat clearing
Chronic cough
Trouble swallowing
Feeling of a lump in the throat, or “something in my throat”
Excessive mucus
Post-nasal drip
Breathing problems

Gastroesophageal Reflux Disease (GERD), commonly referred to as reflux, is different from laryngopharyngeal reflux. GERD involves a backflow of acid, pepsin and other enzymes from the stomach into the swallowing tube or esophagus. Some reflux is normal, but when it happens frequently, acid and pepsin can irritate and damage the lining on the inside of the esophagus. The most common symptom is heartburn, but many people with reflux never experience the symptom of heartburn.

What can I do to control reflux?

There are many changes you can make that can have a dramatic effect in reducing reflux. If appropriate, your doctor may prescribe medication. However, some individuals are able to manage reflux through diet and lifestyle changes alone, without medications. While other individuals require a combination of diet and lifestyle changes for reflux and medication. These diet and lifestyle changes include the following:

Avoid or limiting certain foods:

Spicy, acidic (tomato-based foods, citrus or vinegar-based foods)
Fruit juices
Fried foods
Caffeine (such as coffee, tea, soda)
Carbonated beverages

Chocolate
Peppermint
Alcohol
Dairy
Red meat
Any foods that gives you symptoms

During and after meals:

Eat slowly and don’t overeat at meals
Do not lie down for at least 3 hours after meals
Avoid bending over or exercising after eating

Everyday:

Avoid tight or constricting clothing
Avoid smoking, or exposing yourself to second hand smoke
Avoid, when possible, non-steroidal anti-inflammatory drugs (Ibuprofen, Aleve)

Bedtime:

Avoid eating or drinking within 3 hours before bedtime
Elevate the head of the bed

Resources for Additional Information:

Dropping Acid by Jamie Koufman, M.D., and Jordan Stern, M.D., with French Master Chef Marc Bauer. This book contains a list of common foods and their pH levels.