Laryngopharyngeal Reflux

Hello everyone,

 I am Dr. Palak Shroff Bhatti, ENT and head and neck surgeon consultant at Mumbai. I would like to speak on laryngopharyngeal reflux. Now laryngopharyngeal reflux is very closely associated to a popularly known condition that is gastro-oesophageal reflux disease, which is quite common nowadays. Simply put in reflux disease is where the lower esophageal sphincter is loose and so acid comes from the stomach to the oesophagus and to your throat. Now, the conditions causing these are spices, stress, unhealthy food habits, unhealthy lifestyle and many more and the patient normally presents with a mild sore throat. A recurrent sore throat which is irritating, grating sensation in throat, mild hoarseness, lump in throat, clearing of throat on and off, sticking of mucus inside throat due to which the person will keep on coughing and trying to remove his expectoration, thinking that it is expectoration and it is not mucus.

Chronic dry cough and difficulty in swallowing due to repeated attempts of coughing and trying to swallow very hard. Now in this condition, one must visit an ENT surgeon and have a thorough check-up. In which the surgeon will do your ear, nose and throat examination including your laryngeal examination with an indirect laryngoscope that is simply a mirror put in your throat just to see your voice box or he can use a 70°scope also see to your voice box. Now there are certain investigations that are seen on examination, we recommend that is barium studies, that barium swallow or an upper GI endoscopy which normally is referred to the gastroenterologist. Now the treatment for this is definitely lifestyle changes such as bland diet, small frequent meals, avoiding to sleep just after the meal preferably, eat two hours before bedtime, head elevation while sleeping if there are recurrent cough and regurgitation and having a healthy lifestyle.

Only in a few cases, surgical correction is offered and that too by the general surgeon, which involves plication of the diaphragmatic area where there is light hernias. The do's and don'ts, mainly the don'ts. Avoid excessive clearing of the throat, avoid taking over-the-counter medications. Just when you have simple symptoms you just go to the pharmacist, take medicine, that should be avoided and eating acidic foods, eating tobacco, alcohol, excessive use of beverages like caffeine, tea etc and Do’s, maintain a healthy weight, a healthy weight not a low weight, relaxation, regular exercises and taking food or your meals at proper intervals.

If not treated what can happen? mainly sore throat, chronic cough and there is swelling of the vocal cords which will give you a very raspy voice and worsening of any chest condition like asthma or chronic obstructive lung disease. In worst cases, it can cause cancer. So my suggestion is please recognize symptoms, live a healthy lifestyle and at the slightest suspicion, it's better to show the ENT surgeon and the gastroenterologist for a proper evaluation and treatment of your condition.

Thank you!