Reflux

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Reflux is the term used for laryngopharyngeal reflux, or LPR. It is also known as extra esophageal reflux, acid reflux, or silent reflux. These are confusing terms but they described and the irritation that occurs on the vocal folds from stomach acid and enzymes that injure the vocal folds. These terms are used because most patients do not experience the symptoms associated with gastroesophageal reflux disease, or GERD. Reflux causes irritation and swelling in the vocal folds and results in hoarseness, lump in the throat, throat clearing and postnasal drip. Sometimes if the irritation is severe enough it may cause coughing or chronic throat clearing or even a spasm of the voice box that is experienced as loss of the voice or even difficulty breathing. In some patients the symptoms are treated for a long time as other conditions including asthma or chronic cough.

We currently do not have a complete understanding of the many ways and which it causes the symptoms that it does in patients. It is important to keep in mind that reflux is a specific diagnosis that follows having the voice box examined visually. The treatment includes lifestyle modifications including minimizing triggers, maximizing the ideal environment for healing in the larynx, and medications. Reflux is a common problem and a chronic problem and generally not one that is “cured.” The medical treatment is complicated and is always been updated. Occasionally, a specific problem can be identified which is leading to the reflux event causing the problem. Sometimes this can be an anatomic problem (for example, hiatal hernia) that may be corrected surgically. Most often, reflux that affects the voice is a problem that can be identified and managed successfully.