Madeleine Hull
Laryngopharyngeal reflux (LPR) is a form of gastroesophageal reflux disease (GERD) that occurs when stomach acid and other contents of the stomach flow up the oesophagus, into the back of the throat and, sometimes, into the nasal passages. Symptoms include frequent coughing, throat clearing, hoarseness and other voice problems. While medication is often recommended for adults with LPR, diet and lifestyle changes are also important. A low-acid diet that includes melons, green leafy vegetables, celery and bananas is recommended, while spicy, fried and fatty foods, citrus fruits, tomatoes, chocolate, peppermint, cheese and garlic should be avoided.
| Characteristics | Values |
|---|---|
| Treatment | Medication, diet and lifestyle changes, surgery |
| Medication | Omeprazole, antacids, proton pump inhibitors, acid-blocking medication |
| Diet | Low-acid foods, melons, green leafy vegetables, celery, bananas, fat-free yogurt |
| Foods to Avoid | Spicy, fried, fatty foods, citrus fruits, tomatoes, chocolate, peppermint, cheese, garlic, caffeine, carbonated beverages, alcohol |
| Lifestyle Changes | Eating largest meal midday or in the morning, avoiding eating within 3 hours of bedtime, eating slowly, addressing habits like smoking, drinking alcohol or coffee, adjusting sleep |
| Surgery | Nissen fundoplication, Transoral Incisionless Fundoplication (TIF) |
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What You'll Learn
- Laryngopharyngeal reflux (LPR) is acid reflux that affects the throat and voice
- A low-acid diet is recommended to ease LPR symptoms
- Trigger foods to avoid include spicy, fried, fatty foods, citrus fruits, tomatoes, chocolate, and peppermint
- Lifestyle changes such as eating smaller meals, losing weight, and quitting smoking may help
- Surgery is rarely needed for LPR unless there is a defect in the esophageal sphincter muscles
Laryngopharyngeal reflux (LPR) is acid reflux that affects the throat and voice
Laryngopharyngeal reflux (LPR) is a form of gastroesophageal reflux disease (GERD) that occurs when stomach acid and other contents of the stomach flow up the oesophagus, into the back of the throat and, sometimes, the nasal passages. This can cause a range of symptoms, including a persistent cough, hoarseness, and the feeling of having something stuck in the throat.
LPR can also cause inflammation in areas not protected against gastric acid exposure, such as the throat and voice box. This can result in voice problems and other issues, such as silent reflux, where few or no symptoms are present until the disease has progressed. Due to the lack of typical symptoms, silent reflux can be challenging to diagnose.
Dietary adjustments are often recommended to reduce the symptoms of LPR and address its possible causes. A low-acid diet that includes green leafy vegetables, celery, melons, and bananas can help manage LPR. It is also beneficial to avoid certain foods that can trigger acid reflux, such as spicy, fried, and fatty foods, citrus fruits, tomatoes, chocolate, peppermint, cheese, and garlic. Alcohol, caffeine, and carbonated beverages can also worsen symptoms. Eating smaller meals, with the largest meal of the day in the morning or midday, and avoiding meals within three hours of bedtime are other dietary strategies to manage LPR.
In addition to dietary changes, lifestyle modifications, and medication can help manage LPR. Losing weight, quitting smoking, and reducing stress and anxiety may also alleviate symptoms. In rare cases, surgery may be recommended if other treatments are ineffective or if there is an anatomical defect affecting the oesophageal sphincter muscles, such as a hiatal hernia.
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A low-acid diet is recommended to ease LPR symptoms
Laryngopharyngeal reflux (LPR) is a form of gastroesophageal reflux disease (GERD) that occurs when stomach acid and other contents of the stomach flow up the oesophagus, into the back of the throat, and sometimes into the nasal passages. Frequent coughing, throat clearing, and hoarseness are common symptoms.
In addition to a low-acid diet, drinking alkaline water may further help to reduce symptoms of LPR. A 2020 study found that a plant-based Mediterranean diet combined with alkaline water was slightly more effective than proton pump inhibitors (PPIs) in treating LPR. Alkaline water is water that has been treated to make it less acidic.
It is important to note that dietary changes are not the only way to manage LPR. Medications, such as proton pump inhibitors, antacids, and histamine antagonists, can also help reduce symptoms. Complementary therapies, such as acupuncture and voice therapy, may also be beneficial.
If you are experiencing symptoms of LPR, it is important to speak to a healthcare professional for advice and guidance on managing your symptoms.
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Trigger foods to avoid include spicy, fried, fatty foods, citrus fruits, tomatoes, chocolate, and peppermint
Laryngopharyngeal reflux (LPR) is a form of gastroesophageal reflux disease (GERD) that occurs when stomach acid and other contents of the stomach flow up the oesophagus, into the back of the throat and, sometimes, into the nasal passages. Frequent coughing and throat clearing are common symptoms. LPR can also cause hoarseness and other voice problems.
Diet plays a major role in controlling acid reflux symptoms and is the first line of therapy used for people with GERD. Eating certain foods may offer relief from symptoms. For example, non-fat milk can act as a temporary buffer between the stomach lining and acidic stomach contents, providing immediate relief from heartburn symptoms. Low-fat yoghurt has the same soothing qualities, along with a healthy dose of probiotics, which enhance digestion. Ginger is also one of the best digestive aids due to its medicinal properties. It is alkaline in nature and anti-inflammatory, which eases irritation in the digestive tract.
However, eating some foods may worsen LPR symptoms. Trigger foods to avoid include spicy, fried, and fatty foods; citrus fruits; tomatoes; chocolate; peppermint; cheese; and garlic. Fatty foods generally lower pressure on the lower oesophageal sphincter (LES) and delay stomach emptying, which may increase the risk of reflux symptoms. Spicy foods can cause abdominal pain and burning symptoms in people with a functional gastrointestinal disorder. Capsaicin, the chemical compound that makes food taste spicy, can irritate parts of the oesophagus, resulting in acid reflux.
In addition to avoiding trigger foods, people with LPR can help control their symptoms by eating smaller meals, consuming the largest meal of the day at midday or in the morning, and avoiding eating within three hours of bedtime. It is also important to eat slowly, without distractions, and to remain upright for a couple of hours after eating.
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Lifestyle changes such as eating smaller meals, losing weight, and quitting smoking may help
Lifestyle changes are a crucial aspect of managing laryngopharyngeal reflux (LPR), a form of acid reflux where stomach acid travels up to the throat, causing irritation and inflammation. Here are some detailed lifestyle modifications that can help alleviate LPR symptoms:
Eating smaller meals
It is recommended to eat smaller meals more frequently throughout the day. Instead of three large meals, try having five to six mini meals. Eating larger meals expands the abdomen and increases digestion time, which can worsen reflux. Spacing out smaller meals throughout the day helps reduce the amount of acid reflux reaching the throat. It is also advisable to eat the largest meal of the day at midday or in the morning and avoid eating within three hours of bedtime.
Losing weight
Obesity is a contributing factor to LPR as it causes constant abdominal pressure that can weaken the lower esophageal sphincter (LES) over time. Reducing abdominal volume by losing weight can help alleviate this pressure and strengthen the LES, thus reducing reflux. A healthcare provider can discuss healthy weight loss options and guide individuals on their journey.
Quitting smoking
Smoking increases laryngeal inflammation and LPR. Tobacco smoke relaxes the LES, allowing stomach acid to travel upwards more easily. Smoking is also associated with coughing, which puts chronic pressure on the LES. Quitting smoking can significantly improve LPR symptoms and reduce irritation. Healthcare providers can offer resources and support to help individuals quit smoking.
Additional lifestyle changes
Other lifestyle modifications that may help include avoiding rich, spicy, acidic, and fatty foods; eating slowly; sleeping on the left side; avoiding carbonated beverages; and reducing alcohol consumption. Making these changes can reduce acid reflux and protect the throat and voice during the healing process.
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Surgery is rarely needed for LPR unless there is a defect in the esophageal sphincter muscles
Laryngopharyngeal reflux (LPR) is a multifactorial syndrome that occurs when stomach acid and other contents of the stomach flow up the oesophagus, into the back of the throat, and sometimes into the nasal passages. Symptoms include throat clearing, coughing, hoarseness, and the feeling of having something stuck in the throat. LPR can be challenging to diagnose and treat due to uncertainties surrounding its underlying pathology.
The initial management of LPR typically involves lifestyle modifications and oral medications. Dietary changes play a crucial role in alleviating LPR symptoms. A low-acid diet is recommended, including foods such as melons, green leafy vegetables, celery, and bananas. It is advisable to avoid spicy, fried, and fatty foods; citrus fruits; tomatoes; chocolate; peppermint; cheese; and garlic. Caffeine, carbonated drinks, and alcohol can also exacerbate symptoms. Eating smaller meals and having the largest meal of the day at midday or in the morning, rather than in the evening, is suggested.
In terms of medication, proton pump inhibitors (PPIs) are often the first line of treatment. If patients do not respond well to PPI therapy, other options include prokinetic drugs, H2 blockers, and antacids. However, antacids should not be used in isolation to treat LPR and are typically recommended as an add-on therapy.
While surgery is rarely needed for LPR, it may be considered in cases where there is a defect in the oesophageal sphincter muscles, such as a hiatal hernia. Laparoscopic fundoplication is the surgery of choice and can repair a hiatal hernia and reinforce the lower oesophageal sphincter. Preoperative oesophageal impedance monitoring can help identify patients who will benefit from anti-reflux surgery.
In conclusion, LPR management primarily focuses on dietary and lifestyle modifications, with surgery being a rare option reserved for specific cases.
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Frequently asked questions
Laryngopharyngeal reflux (LPR) is a form of gastroesophageal reflux disease (GERD) where stomach acid and other contents of the stomach flow up the oesophagus, into the back of the throat and, in some cases, into the back of the nasal passages.
While medication is a standard treatment option for laryngopharyngeal reflux, diet and lifestyle changes are also recommended to ease symptoms. Eating a diet low in acid can help reduce symptoms.
Foods that people with laryngopharyngeal reflux should avoid include spicy, fried and fatty foods; citrus fruits; tomatoes; chocolate; peppermint; cheese; and garlic. Foods and drinks that contain caffeine, carbonated beverages and alcohol can also worsen symptoms.
Examples of low-acid foods that can be eaten as part of a laryngopharyngeal reflux diet include melons, green leafy vegetables, celery and bananas.
