Laryngopharyngeal reflux

When acid reflux leads to persistent heartburn, occurring maybe twice a week for 3 weeks or more, this is known as gastroesophageal reflux disease, or GERD. Silent reflux, or laryngeal-pharyngeal reflux (LPR), is similar, but without the heartburn and indigestion. Laryngopharyngeal reflux (LPR) is similar to another condition — GERD — that results from the contents of the stomach backing up (reflux). But the symptoms of LPR are often different than those that are typical of gastroesophageal reflux disease (GERD).

Hyaluronic acid (HA) is a biopolymer with medium molecular weight characterized by optimal hygroscopic and hydrodynamic features. The chemical-physical properties of the polymeric complex confer mucoadhesiveness to E-Gastryal® so increasing the contact surface and the residence time on the mucous membranes of larynx, pharynx, and esophagus. In this context, hyaluronic acid is extremely bioavailable and able to carries out its activity aimed to induce repairing and regenerating the damaged epithelium.

Along with the accumulation of mucus can come other throat symptoms such as hoarseness, throat clearing and chronic cough, sore throat, sensation of having something stuck in the throat and trouble swallowing. Acid reflux can also cause a post-nasal drip, which may be related to sinusitis or inflammation of the sinuses. Acid reflux occurs when acidic stomach contents leak up into the esophagus, and it is most commonly associated with symptoms like heartburn. If stomach acid irritates the throat or goes into the lungs, it can cause problems like excessive mucus production and wheezing.

A. It sounds as though you have a condition called laryngopharyngeal reflux (LPR). This occurs when stomach contents, including acid and enzymes, back up into the esophagus and injure the tissues of the larynx (voice box) and pharynx (throat). The cause is malfunctioning of the upper and lower esophageal sphincter muscles. These muscles are supposed to keep food moving in the right direction, from mouth to stomach.

For example, high-fat and salty foods can make GERD worse, while eggs and some fruits can improve it. Learn which foods are beneficial here. LPR has the name “silent reflux” due to not necessarily triggering the usual symptoms of acid reflux, such as heartburn. However, silent reflux can lead to hoarseness, frequent throat-clearing, and coughing.

Compliance with therapy should be verified first by the physician, and the presence of functional gastrointestinal disorders, psychological distress, functional heartburn or other esophagitis not related to reflux should also be carefully evaluated in these patients. The prevalence of GERD in the primary care setting seems to be even more evident when one considers that, in the United States, 4.6 million office encounters annually are primarily for GERD, whereas 9.1 million encounters include GERD in the top 3 diagnoses for the encounter. GERD constitutes also the most frequently first-listed gastrointestinal diagnosis in ambulatory care visits [2, 3].

The test is done to identify and biopsy scar or abnormal growths in the esophagus. It can also show inflammation of the esophagus caused by gastroesophageal reflux. Attempts to improve vocal hygiene should be undertaken.

On the other hand our throat, and specifically the vocal cords (aka the larynx) are located much further away from the stomach than the esophagus is. Also, the vocal cords are especially sensitive to acid exposure.

These patients might have a chronic cough or repetitive throat clearing, or they experience changes in the tenor of their speech (pace, voice pattern, or pitch). Their laryngeal inflammation can worsen even though their GERD has resolved. In the prospective trials on GERD and laryngopharyngeal reflux disease, when they performed a meta-analysis, it suggested that these patients have increased response to antireflux therapy. However, when they adjusted for a variety of other factors, they found that patients didn’t respond to GERD therapy if they didn’t have GERD.

A reflux action causes these uncomfortable sensations. Reflux refers to a backward or return flow. In LPR, stomach acid flows back into the esophagus and irritates the throat.

It can also happen with spicy food and caffeine, which allow the band of muscle separating the stomach and esophagus to relax and open. Once acidic digestive juices move upward, they can cause swelling in the throat, forming a “shelf” on which mucus accumulates.

Call Your Doctor About GERD If:

Learn about treatments, prevention methods, and other causes of chronic coughing. Silent reflux is a condition in which stomach acid causes throat discomfort, especially behind the breastbone in the middle of the trunk. Some people respond well to self-care and medical management. However, others need more aggressive and lengthy treatment.

Differential Diagnosis

With LPR, you may not have the classic symptoms of GERD, such as a burning sensation in your lower chest (heartburn). That’s why it can be difficult to diagnose and why it is sometimes called silent reflux.

If untreated, chronic aspiration can damage the lungs by causing inflammation, infection and scarring. Nighttime aspiration can be reduced by sleeping with the head of the bed at an incline of several inches, to prevent stomach contents from traveling up into the esophagus. It is also best to avoid late-night meals.

The chemical-physical properties of the polymeric complex confer mucoadhesiveness to E-Gastryal® so increasing the contact surface and the residence time on the mucous membranes of larynx, pharynx, and esophagus. Presently, the newest alginate compounds renowned the interest in this attracting and stimulating area. In this regard, a new medical device (Marial®), unique still now possessing the indication for both GERD and LPR, has been recently launched in the Italian market. It is an innovative gel compound, containing magnesium alginate and E-Gastryal® (hyaluronic acid, hydrolyzed keratin, Tara gum, and Xantana gum). E-Gastryal® is a complex of phyto-polymers, Tara and Xantana gums, that are natural polysaccharides with high molecular weight and partially hydrosoluble, and able to provide viscosity to the solution and to generate a support frame where keratin peptide chains and hyaluronic acid anchor.

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