Gastroesophageal Reflux (GERD) vs. Laryngopharyngeal Reflux (LPR)

We are still learning a lot about how reflux affects individuals differently. Although everyone refluxes, not everyone experiences it in the same way. Those who experience common, telltale signs often may have acid reflux. When acid reflux is chronic or severe, people may be suffering with Gastroesophageal Reflux (GERD) or Laryngopharyngeal Reflux (LPR). Doctors typically only treat those individuals who are showing signs.

GERD and LPR are two types of acid reflux with different manifestations. Not all people who suffer from GERD will have signs of LPR.

Gastroesophageal Reflux

The vast majority of individuals who suffer from Gastroesophageal Reflux (GERD) complain of heartburn. Most complaints relate to the stomach and abdominal area.

Common signs of GERD may include:

  • Pain in the abdomen between meals
  • Nausea
  • Feeling of having an upset stomach
  • Sourness of the stomach
  • Excessive burping

If the esophagus is injured, people may also complain of pain in the chest that can be mistaken for a heart attack. We often think of GERD as reflux that happens when patients are lying down or in a head-dependent position.

Heartburn is fairly common in adults; however, you may want to see a doctor if your heartburn is persistent and you experience other signs.

Laryngopharyngeal Reflux

On the other hand, people who suffer from Laryngopharyngeal Reflux (LPR), also known as Extra-Esophageal Reflux, complain of signs that refer to the throat/voice box region. In fact, it is sometimes called “silent reflux,” but people often don’t experience common manifestations like heartburn or indigestion.

Signs of LPR include:

  • Hoarseness
  • Chronic cough
  • Chronic throat irritation
  • Thick or too much mucus
  • Difficulty swallowing
  • Chronic throat clearing
  • Voice problems

Only about 35% of people who suffer from LPR complain of heartburn. Because common manifestations resemble respiratory problems, this can make LPR harder to diagnose.

We tend to think of LPR sufferers as “upright refluxers” (meaning refluxing throughout the day, especially after meals).

Can GERD and LPR Occur Together?

Because of the way our bodies are built to handle reflux, GERD and LPR manifestations are not typically experienced at the same time; however, both conditions can occur together. The organs that are most affected by acid reflux are the esophagus and the larynx.

The esophagus

The esophagus and stomach are built to handle acid. The lining of the stomach has a thick layer of mucus that helps to protect it from the acidic environment that it finds itself in most of the time. The esophagus, like the skin, is made of resilient squamous epithelium that is able to handle the elements, including stomach acid.

The esophagus has the ability to secrete substances that can neutralize acids, further decreasing the chances that the esophagus will be injured by reflux. The esophagus can also move acidic contents back toward the stomach and decrease the amount of contact time it has with this acidic refluxate through peristalsis (the ability of the esophagus to contract rhythmically and move contents towards the stomach).

The Larynx

Unfortunately, the larynx is lined by more delicate and sensitive mucosa that does not have the same robustness as the esophagus, and can be injured by as little as four reflux events a day (compared to 40 events or more in the esophagus). Although the larynx can create a mucus layer to help protect itself, this mucus is nowhere as thick or as effective as the mucus that the stomach makes.

The larynx is unable to make the same acid-neutralizing substances as the esophagus, and it cannot get out of the way of acidic contents if they happen to get to the larynx. This combination makes it possible for someone to have symptoms in the throat region with mild reflux and not complain of any difficulties in the esophagus or stomach. In other words, GERD and LPR can occur together, but many patients may experience signs of one condition without experiencing signs of the other. 

Managing GERD and LPR

Acid reflux, regardless of the type, is a lifelong battle. Although the manifestations of GERD and LPR are different, they are addressed the same way, as they are very similar conditions. Managing all reflux often requires a combination of lifestyle changes such as diet, and medications.

Common over-the-counter medications that can be used in GERD and LPR include:

  • Antacids
  • H2 receptor blockers
  • Proton pump inhibitors (PPIs)

These medications work by reducing or preventing stomach acid secretions. Alternative therapies like deglycyrrhizinated licorice or alginates are also used to address acid reflux.

Safe Reflux Relief

For people with GERD or LPR who want a safe, natural road to reflux relief, alginate therapy may be the answer. Alginate therapy harnesses the natural healing ability of kelp. Alginate is an all-natural polymer harvested from brown seaweed (kelp). Alginates have been used as a main ingredient in natural food thickeners and jellies. Alginates have no known side effects.

In clinical studies, alginates alone have been proven effective in addressing reflux. Unlike other options, in addition to relieving the pain of reflux, alginate therapy actually stops reflux from happening.

Whatever road you choose to take on the journey to finding comfort and health, doing so in partnership with wonderful physicians is key to ensuring you are safely and effectively cared for.

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