A report on Laryngopharyngeal reflux

Sagittal illustration of the anterior portion of the human head and neck. In LPR, the pharynx (1), oropharynx (2) and larynx (3) are exposed to gastric contents that flow upward through the esophagus (4).
Illustration of the superior view of the larynx. Tissues lining laryngeal structures, including the vocal folds, may be damaged in LPR.

Retrograde flow of gastric contents into the larynx, oropharynx and/or the nasopharynx.

- Laryngopharyngeal reflux
Sagittal illustration of the anterior portion of the human head and neck. In LPR, the pharynx (1), oropharynx (2) and larynx (3) are exposed to gastric contents that flow upward through the esophagus (4).

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X-ray showing radiocontrast from the stomach (white material below diaphragm) entering the esophagus (three vertical collections of white material in the mid-line of the chest) due to severe reflux

Gastroesophageal reflux disease

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Chronic condition in which stomach contents and acid rise up into the esophagus, resulting in symptoms and/or complications.

Chronic condition in which stomach contents and acid rise up into the esophagus, resulting in symptoms and/or complications.

X-ray showing radiocontrast from the stomach (white material below diaphragm) entering the esophagus (three vertical collections of white material in the mid-line of the chest) due to severe reflux
Frontal view of severe tooth erosion in GERD.
Severe tooth erosion in GERD.
A comparison of a healthy condition to GERD
Endoscopic image of peptic stricture, or narrowing of the esophagus near the junction with the stomach: This is a complication of chronic gastroesophageal reflux disease and can be a cause of dysphagia or difficulty swallowing.

GERD sometimes causes injury of the larynx (LPR).

Anatomy of the larynx, anterolateral view

Larynx

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Organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration.

Organ in the top of the neck involved in breathing, producing sound and protecting the trachea against food aspiration.

Anatomy of the larynx, anterolateral view
Sagittal section of the larynx and upper part of the trachea.
The basic parts of the human larynx.
Vocal cords abducted and adducted
Extrinsic laryngeal muscles
Image of endoscopy
Endoscopic image of an inflamed human larynx
Larynx. Deep dissection. Anterior view.
Larynx. Deep dissection. Posterior view.

Laryngopharyngeal reflux is a condition in which acid from the stomach irritates and burns the larynx. Similar damage can occur with gastroesophageal reflux disease (GERD).

The vocal folds (or vocal cords) in the larynx vibrate to produce sound. When this process is disturbed hoarseness may ensue.

Hoarse voice

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When the voice involuntarily sounds breathy, raspy, or strained, or is softer in volume or lower in pitch.

When the voice involuntarily sounds breathy, raspy, or strained, or is softer in volume or lower in pitch.

The vocal folds (or vocal cords) in the larynx vibrate to produce sound. When this process is disturbed hoarseness may ensue.
The vocal folds (or vocal cords) in the larynx vibrate to produce sound. When this process is disturbed hoarseness may ensue.

The most common laryngeal diagnoses among the elderly are polyps, laryngopharyngeal reflux, muscle tension dysphonia, vocal fold paresis or paralysis, vocal fold mass, glottic insufficiency, malignant lesions, and neurologic conditions affecting the larynx.

Globus pharyngis

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Persistent but painless sensation of having a pill, food bolus, or some other sort of obstruction in the throat when there is none.

Persistent but painless sensation of having a pill, food bolus, or some other sort of obstruction in the throat when there is none.

The "lump in the throat" sensation that characterizes globus pharyngis is often caused by inflammation of one or more parts of the throat, such as the larynx or hypopharynx, due to cricopharyngeal spasm, gastroesophageal reflux (GERD), laryngopharyngeal reflux or esophageal versatility.

Muscle tension dysphonia

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Originally coined in 1983 by Morrison and describes a dysphonia caused by increased muscle tension of the muscles surrounding the voice box: the laryngeal and paralaryngeal muscles.

Originally coined in 1983 by Morrison and describes a dysphonia caused by increased muscle tension of the muscles surrounding the voice box: the laryngeal and paralaryngeal muscles.

Larynogopharyngeal reflux, a process that is similar to GERD, can bring stomach acid into the larynx.

General structure of a proton-pump inhibitor

Proton-pump inhibitor

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Proton-pump inhibitors (PPIs) are a class of medications that cause a profound and prolonged reduction of stomach acid production.

Proton-pump inhibitors (PPIs) are a class of medications that cause a profound and prolonged reduction of stomach acid production.

General structure of a proton-pump inhibitor
The activation of PPIs

Gastroesophageal reflux disease (GERD or GORD) including symptomatic endoscopy-negative reflux disease and associated laryngopharyngeal reflux causing laryngitis and chronic cough

Beeman's Pepsin Gum

Pepsin

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Endopeptidase that breaks down proteins into smaller peptides.

Endopeptidase that breaks down proteins into smaller peptides.

Beeman's Pepsin Gum
Adams Pepsin Tutti Frutti Gum, marketed "For relief of indigestion and dyspepsia"

The stability of pepsin at high pH has significant implications on disease attributed to laryngopharyngeal reflux.