Laryngoesophageal Reflux (LPR): An Acid-Reflux That Does Dot Cause Heartburn

What is Laryngoeseophageal Reflux (LPR)? 

Acid reflux is a very common gastrointestinal disorder.  In western culture, 1 in 5 people experience acid reflux.  Most people think of acid reflux as heartburn, but acid reflux does not always cause a burning sensation in the chest.  Some of my patients are surprised when I diagnose them with acid reflux.  The medical term for this type of acid reflux is Laryngoeseophageal Reflux (LPR).  People with LPR will describe their symptoms as chronic sore throat, chronic cough, a voice that gets tired easily, voice hoarseness, the need to clear the throat constantly because of phlegm, trouble swallowing, and oftentimes a feeling that something is stuck in the throat.  They may also have other health conditions, such as asthma, sinus congestion, erosion of teeth, frequent ear infection, bad breath, sleep apnea, or snoring. They experience their symptoms more during the day and while standing up.   

The Cause of LPR

The main reason that they experience their symptoms primarily in the throat is because of the activation of pepsin.  Pepsin is an enzyme that helps you digest protein. It is activated in an acidic environment from pepsinogen.  When your foods move into the stomach, your stomach produces pepsinogen and gastric acid, mixing these digestive juices well with your foods.  Pepsin, activated by the gastric acid, breaks protein into smaller pieces.  When you have acid reflux, the reflux can carry pepsin or pepsinogen all the way up to the throat, trachea, mouth, and even the middle ear.  Our throat and voice box are a hundred times more sensitive to irritation and damage.  These pepsinogens or pepsin will latch on these vulnerable tissues and remain stable for a long time.  They cause damage when they are activated by any acidic foods you eat or when there is acid reflux from the stomach.  In the voice box, as few as three episodes a week can be too much for an individual. 

Treatment for LPR

To treat LPR, a change in diet is a must.  About 1/3 of my patients can become symptom-free by modifying the diet alone.  About 2/3 of patients require a combination of diet and medication, whether drugs or natural therapies.  If you find yourself experiencing similar symptoms, please seek a medical professional for proper diagnosis and treatment.   


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