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Laryngopharyngeal reflux (LPR) or laryngopharyngeal reflux disease (LPRD) is the retrograde flow of gastric contents into the larynx, oropharynx and/or the nasopharynx. [4] [5] LPR causes respiratory symptoms such as cough and wheezing [6] and is often associated with head and neck complaints such as dysphonia, globus pharyngis, and dysphagia. [7]
A hiatal hernia or hiatus hernia [2] is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest. [1] [3] This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn.
Other symptoms may include a runny nose, cough, headache, difficulty swallowing, swollen lymph nodes, and a hoarse voice. [1] [6] Symptoms usually last 3–5 days, but can be longer depending on cause. [2] [3] Complications can include sinusitis and acute otitis media. [2] Pharyngitis is a type of upper respiratory tract infection. [7]
Sensory testing can quantify and assess the swelling for better treatment. The strength of the air pulse given during sensory testing in acid-injured vocal cords due to acid reflux disease will necessarily be much greater in order to elicit an airway reflex than tissues that are not swollen. [18] [19] [20]
However, the symptoms of chest pain and trouble swallowing may be severe enough to require treatment with medications, and rarely, surgery. The initial step of treatment focuses on reducing risk factors. While weight reduction may be useful in reducing symptoms, the role of acid suppression therapy to reduce esophageal reflux is still uncertain ...
The diagnosis of GERD is usually made when typical symptoms are present. [42] Reflux can be present in people without symptoms and the diagnosis requires both symptoms or complications and reflux of stomach content. [43] Other investigations may include esophagogastroduodenoscopy (EGD). Barium swallow X-rays should not be used for diagnosis. [42]
Anti-reflux medications may be prescribed for patients with signs of chronic laryngitis and hoarse voice. [24] If anti-reflux treatment does not result in a decrease of symptoms, other possible causes should be examined. [1] Over-the-counter medications for neutralizing acids and acid suppressants (H-2 blockers) may be used. [7]
In gastroenterology, esophageal pH monitoring is the current gold standard for diagnosis of gastroesophageal reflux disease (GERD). It provides direct physiologic measurement of acid in the esophagus and is the most objective method to document reflux disease, assess the severity of the disease and monitor the response of the disease to medical or surgical treatment.