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 10 people who see a throat doctor has laryngopharyngeal reflux (LPR), a type of acid reflux that causes sticky enzymes normally found in the stomach to travel to the throat and larynx, causing other symptoms such as chronic cough and difficulty swallowing.
However, the condition is largely undiagnosed, which is why it has been nicknamed “silent reflux.”
Up to 30 million Americans could be living with LPR to varying degrees.
Symptoms of LPR include hoarseness, a feeling that something is stuck in the throat, chronic cough, excessive mucus, difficulty swallowing, sore throat, loss of voice, wheezing, bad taste in the mouth, and new or worsening asthma.
Constant throat clearing is one of the main symptoms of LPR
If left untreated, LPR can cause frequent throat and sinus infections, chronic throat and voice irritation, and vocal cord injuries.
LPR is a type of gastroesophageal reflux disease (GERD), also known as chronic acid reflux.
GERD occurs when stomach contents rise toward the lower part of the esophagus, near the chest. This can cause symptoms such as chest pain that does not burn, regurgitation of bitter liquid in the throat or mouth, and difficulty swallowing.
However, with LPR, stomach acid increases even more, affecting the larynx and throat.
For this to happen, stomach acid has to bypass the upper and lower esophageal sphincters, which normally protect the esophagus.
In LPR, the upper esophageal sphincter relaxes, allowing reflux already in the esophagus to travel 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 aromatic products such as garlic and onion 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 this 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 the symptoms mimic other conditions, leading it to be called “silent reflux.”
Symptoms include hoarseness, feeling like something is stuck in the throat, throat clearing, chronic cough, excess mucus, difficulty swallowing, sore throat, loss of voice, wheezing, bad taste in the mouth, and new or worsening asthma.
Some patients may have LPR and GERD at the same time.
If left untreated, LPR can cause 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 treatable.
LPR can be treated with acid blockers such as omeprazole (Prilosec) and lansoprazole (Prevacid).
Reducing consumption of foods that relax the esophageal sphincters, such as coffee and alcohol, may also reduce symptoms.