If your voice sounds hoarse and you can’t stop clearing your throat, you may have an often overlooked form of acid reflux.
One in ten people who see a throat doctor have laryngopharyngeal reflux (LPR), a type of acid reflux that causes sticky enzymes normally found in the stomach to travel to the throat and larynx, leading to other symptoms such as chronic coughing and swallowing problems.
However, the condition goes largely undiagnosed, which is why it is sometimes called ‘silent reflux’.
As many as 30 million Americans could be living with LPR to varying degrees.
Symptoms of LPR include hoarseness, feeling like something is stuck in your throat, chronic cough, excessive mucus, difficulty swallowing, sore throat, loss of voice, wheezing, a bad taste in your mouth, and new or worsening asthma
Constant throat clearing is one of the main symptoms of LPR
If left untreated, LPR can lead to frequent throat and sinus infections, chronic irritation of the throat and voice, and vocal cord lesions.
LPR is a form of gastroesophageal reflux disease (GERD), also known as chronic acid reflux.
GERD occurs when stomach contents move up into the lower esophagus, close to the chest. This can cause symptoms such as: non-burning chest pain, belching of bitter liquid in the throat or mouth, and difficulty swallowing.
However, with LPR, stomach acid creeps up even further, affecting the larynx and throat.
For this to happen, stomach acid must bypass the upper and lower esophageal sphincters, which normally guard the esophagus.
With LPR, the upper esophageal sphincter relaxes, allowing reflux that is already in the esophagus to flow further into the throat.
Certain medications such as tricyclic antidepressants (TCAs), nonsteroidal anti-inflammatory drugs (NSAIDs), and menopausal hormone therapy medications can relax this sphincter.
Coffee, chocolate, alcohol and aromatics such as garlic and onions can also make this barrier less effective.
According to the Cleveland Clinic, about 10 percent of people who visit a throat specialist have LPR, and at least half of patients who complain of chronic hoarseness have the condition.
An estimated 60 million Americans complain of chronic acid reflux, meaning at least half of them could have LPR.
However, LPR can be difficult to diagnose because its symptoms are similar to other conditions, earning it the nickname “silent reflux.”
Symptoms include hoarseness, feeling like something is stuck in your throat, clearing your throat, chronic cough, excessive mucus, difficulty swallowing, sore throat, loss of voice, wheezing, a bad taste in your mouth, and new or worsening asthma.
Some patients may have LPR and GERD at the same time.
If left untreated, LPR can lead to frequent throat and sinus infections, chronic voice and throat irritation, and respiratory conditions such as asthma.
However, once the condition is diagnosed, it is easily treated.
LPR can be treated with acid blockers such as omeprazole (Prilosec) and lansoprazole (Prevacid).
Reducing foods that relax the esophageal sphincters, such as coffee and alcohol, can also reduce symptoms.
