Laryngopharyngeal Reflux: Suspect it if you experience throat sensation and hoarseness even without heartburn

Typical gastroesophageal reflux disease (GERD) is characterized by primary symptoms such as heartburn near the solar plexus or the sensation of stomach acid rising. However, 'laryngopharyngeal reflux' (LPR), where stomach acid rises beyond the esophagus to the throat and larynx area, presents a different pattern. Even if there is no heartburn, if you experience a sensation of something stuck in your throat, hoarseness, or repetitive dry coughing, it is necessary to suspect laryngopharyngeal reflux.

Laryngopharyngeal reflux without heartburn: Pay attention to throat symptoms

According to a video from the health medical specialty channel HiDoc, laryngopharyngeal reflux occurs when stomach contents pass through the esophagus to the throat (pharynx) and larynx, irritating the vocal cords and surrounding throat tissues. Because of this, patients often feel throat discomfort before gastrointestinal symptoms. Representative symptoms include the sensation of a foreign object in the throat, changes in voice such as hoarseness, and repetitive dry coughing caused by the feeling of something caught in the throat.

However, it is difficult to definitively diagnose reflux disease based solely on these throat symptoms. This is because throat discomfort can be caused by a wide variety of causes, such as colds, allergies, rhinitis, postnasal drip (mucus flowing down the back of the throat), or vocal cord diseases. The video mentioned that while influenza (the flu) is accompanied by pain, fatigue, and fever, reflux disease tends to have symptoms that recur after meals, after consuming late-night snacks, or in the early morning. In particular, since many patients suffer from both rhinitis and reflux disease simultaneously, a comprehensive evaluation of the nasal condition is required.

Diagnostic methods and lifestyle habits that exacerbate symptoms

To diagnose laryngopharyngeal reflux, doctors closely examine when the patient's symptoms started, the duration, and what their usual eating and sleeping habits are. For an accurate diagnosis, the process of directly checking the condition of the vocal cords and larynx through an endoscopic examination is important. The video explains that endoscopic examination, which checks the state of the vocal cords and larynx, plays a key role in diagnosis.

The most representative factor that exacerbates the disease is improper eating habits. Eating late-night snacks or consuming food right before bedtime are direct causes of stomach acid reflux. The habit of lying down immediately after eating also worsens the symptoms. Additionally, excessive consumption of greasy foods, spicy foods, or alcohol should be avoided. The video emphasized that the habit of going to bed after ensuring sufficient digestion time is more important than anything else. Rather than simply eating large amounts, the habit of allowing sufficient time after a meal before sleeping is more effective for prevention.

Treatment medications and precautions when symptoms persist

The treatment for laryngopharyngeal reflux is based on correcting lifestyle habits. In the case of drug therapy, medications that suppress stomach acid secretion are mainly used. Depending on the case, either PPI (Proton Pump Inhibitor) drugs, which have been used for a long time, or the relatively recently emerged P-CAB (Potassium-Competitive Acid Blocker) class of drugs may be selected. P-CABs are a group of drugs that act competitively with potassium to involve the acid secretion stage, and ingredients such as Fexuprazan belong to this group. However, it is not appropriate to prescribe the same medication to all patients, and the appropriate medication must be selected according to the patient's condition.

If symptoms continue even after improving lifestyle habits and receiving drug treatment, other causes must be investigated. This is because postnasal drip, allergies, vocal cord diseases, or cough hypersensitivity could be the cause. In particular, if the symptom of voice change persists for more than 4 weeks, it is recommended to re-verify whether the initial diagnosis was accurate. Furthermore, if symptoms worsen and are accompanied by weight loss, difficulty breathing, or severe headaches, professional medical treatment must be sought.