Acid Reflux: Coughing, Voice Changes, and LPR
Most people associate acid reflux symptoms with classic heart burn and acid regurgitation. But acid reflux can manifest in other ways and affect more than just the esophagus; for example, it can also affect the throat (pharynx) and voice box (larynx). In fact, for many people, changes in the voice or a chronic cough may be the only acid reflux symptoms they ever experience, but that does not mean it doesn’t need treatment.
People whose acid reflux also affects the pharynx and larynx may receive a diagnosis of laryngopharyngeal reflux disease (LPR). In these instances, you may need to seek the expertise of a gastroenterologist and an otolaryngologist.
A diagnosis of LPR is usually made after a thorough patient history and an examination of the throat and vocal cords with a scope (known as a laryngoscopy). It may also include a pH probe test.
Symptoms of LPR can include:
Chronic cough
Sore throat
Hoarseness
Difficulty swallowing
Changes in voice or vocal range
Sensation of drainage
Feeling of something caught in the throat
Throat clearing
Chronic laryngitis
Choking episodes
Breathing difficulties
Treatment of LPR is generally the same as that of acid reflux, although not everyone with LPR will exhibit the classic heartburn symptoms. PPI medications, just like with acid reflux, are often effective in treating LPR. In some cases, surgery, such as the NISSEN fundoplication, may be recommended when medications don’t resolve the problem.
If you think the cause of your cough or your voice changes may be LPR, it is important to seek the proper treatment. When left untreated, damage caused by LPR is also a risk factor for subglottic stenosis, laryngomalacia, laryngeal stenosis, and laryngeal carcinoma. Seeking the proper treatment can help prevent these complications.
