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LPR occurs when the acid in our stomach flows up into our throat and causes inflammation. Sometimes it may be associated with heartburn, but often it is silent.

Causes

LPR is often associated with our diet and lifestyle habits:

  1. When we eat, our stomach produces acid to aid in digestion
  2. Certain food (e.g. fried and oily food, dairy products) delay the passage of food down our digestive tract, giving the opportunity for acid to backflow from the stomach, up the oesophagus and into our throat
  3. Other food (e.g. alcohol, acidic or spicy food) irritate our stomach lining to produce more acid than usual, which can also backflow
  4. Other causes include lying down right after eating, stress and being overweight
Symptoms

When the lining of our throat becomes inflamed, it can cause:

  1. Sensation of a lump in the throat (globus)
  2. Excessive throat phlegm and throat clearing
  3. Sour taste in the mouth
  4. Chronic cough
  5. Voice change

The symptoms are typically worse soon after eating or when the patient first wakes up in the morning. In severe cases, the patient may experience heartburn, chest pain or indigestion.

Diagnosis
  1. A flexible nasendoscopy may be used to examine the throat and larynx (voicebox) in order to make sure that you do not have any problems (e.g. sinusitis, nasal allergies) that sometimes present the same way as LPR
  2. Less frequently, a scope of the oesophagus and stomach may be used if it is suspected that there is a problem further down; or special studies on the motility of the oesophagus may be conducted
Treatment

Treatment of LPR consists of lifestyle modification, dietary controls and medication.

  1. Lifestyle Modification
    1. Lose weight
    2. Avoid large meals – opt for smaller, more frequent meals instead
    3. Avoid lying down within 3 hours of eating
    4. Avoid tight belts
    5. Stop smoking
    6. Manage stress
  2. Dietary Controls
    1. Reduce caffeine intake
    2. Reduce alcohol intake
    3. Reduce spicy food intake
    4. Reduce citrus fruit intake
  3. Medication
    1. Medicine to reduce the amount of acid produced by the stomach can be taken
    2. Taken 30 minutes before a meal, and for 6-12 weeks
Know Your ENT Specialist
Dr Paul Mok
Senior Consultant ENT Surgeon
MBBS, FRCS (Glasgow), FAMS (ORL)

Dr Paul Mok Kan Hwei is a certified specialist in Otolaryngology, Head and Neck Surgery (ENT) and has had a distinguished career in public service for the past 23 years.

He cares for patients with a wide variety of ENT conditions including managing patients with nasal allergies, sinus infections, ear problems and swellings in the head and neck region. His special areas of interests are in Voice, Swallowing and managing patients with Obstructive Sleep Apnea.