Common laryngopharyngeal reflux: A review

Abstract

Abstract Clinically, gastroesophageal reflux disease (GERD) or gastroesophageal reflux disease (GORD) is a chronic upper gastrointestinal disease characterized by persistent and regular flow of stomach content up into the esophagus, resulting in symptoms and/or complications. Further, if acid reflux symptoms are more apparent in the larynx or pharynx, then the disorder may be called laryngopharyngeal reflux disorder (LPRD). The reflux of such acid to soft tissues beyond the esophagus will cause damage, which may turn into a relatively serious condition, especially for those with laryngeal reflux. Traditionally, obesity has been known as a primary risk factor for GERD or LPRD and related complications. Many studies have reported the association between obesity, hiatus hernia, and various motility dysfunctions of the upper gastrointestinal tract in patients with LPRD. Somehow obesity predisposes to these conditions, or whether they merely coexist with LPRD remains to be elucidated and dissents exist. Previous studies often recommend longer treatment and higher doses of proton pump inhibitors (PPI) for general gastroesophageal reflux because the presence of gastric acid in the pharynx and larynx can damage the vocal cords. Patients with laryngopharyngeal reflux can feel the symptoms while sitting at rest, and those with GERD feel the symptoms when lying down. The stomach contents, including pepsin and gastric acid, are the culprits that cause major damage to the tissues. Bile salts from the gallbladder further worsen the injury. A high-risk population includes people with obesity and/or obstructive sleep apnea.