Acid Reflux: Coughing, Voice Changes, and LPR

by Jennifer Mitchell Wilson B.S. Dietetics, Dietitian, Health Professional

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.

Jennifer Mitchell Wilson
Meet Our Writer
Jennifer Mitchell Wilson

Jennifer Mitchell Wilson is a dietitian and mother of three girls. Two of her children have dealt with acid reflux disease, food allergies, migraines, and asthma. She has a Bachelor of Science in dietetics from Harding University and has done graduate work in public health and nutrition through Eastern Kentucky University. In addition to writing for HealthCentral, she does patient consults and serves on the Board of Directors for the Pediatric Adolescent Gastroesophageal Reflux Association.