If your voice sounds hoarse and you can’t stop clearing your throat, you may have a frequently overlooked form of acid reflux.
One in 10 people who see a throat doctor have laryngopharyngeal reflux (LPR), a type of acid reflux that causes sticky enzymes normally in the stomach to travel to the throat and voice box, leading to other symptoms like chronic coughing and trouble swallowing.
However, the condition goes largely undiagnosed, which is why it has been nicknamed ‘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, losing your voice, wheezing, a bad taste in your mouth, and new or worsening asthma
Constant throat clearing is one of the main symptoms of LPR
Left untreated, LPR can lead to frequent throat and sinus infections, chronic irritation in the throat and voice, and lesions in the vocal cords.
LPR is a type 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 like non-burning chest pain, regurgitating bitter liquid in the throat or mouth, and difficulty swallowing.
With LPR, however, stomach acid creeps up even further, affecting the voice box and the throat.
For this to happen, stomach acid has to bypass the upper and lower esophageal sphincters, which normally guard the esophagus.
In LPR, the upper esophageal sphincter relaxes, allowing reflux already in the esophagus to travel further into the throat.
Certain medications like tricyclic antidepressants (TCAs), nonsteroidal anti-inflammatory drugs (NSAIDs), and hormone therapy drugs for menopause can relax this sphincter.
Coffee, chocolate, alcohol, and aromatics like 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 about chronic hoarseness have the condition.
An estimated 60 million Americans complain of chronic acid reflux, meaning that at least half of them could have LPR.
However, LPR can be difficult to diagnose because the symptoms mimic other conditions, leading it to be nicknamed ‘silent reflux.’
Symptoms include hoarseness, feeling like something is stuck in your throat, throat clearing, chronic cough, excessive mucus, difficulty swallowing, sore throat, losing your voice, wheezing, a bad taste in your mouth, and new or worsening asthma.
Some patients can have LPR and GERD at the same time.
Left untreated, LPR can lead to frequent throat and sinus infections, chronic voice and throat irritation, and respiratory conditions like asthma.
However, once the condition is diagnosed, it’s easily treatable.
LPR can be treated with acid blockers like omeprazole (Prilosec) and lansoprazole (Prevacid).
Cutting down on foods that relax esophageal sphincters, like coffee and alcohol, can also reduce symptoms.
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