Laryngopharyngeal Reflux (LPR) Otolaryngology (ENT)-Head and Neck Surgery What is Laryngopharyngeal Reflux (LPR)?
What are the symptoms of LPR?
LPR occurs when stomach acid flows backwards into the esophagus (gut) and into the throat. This causes irritation to the tissues in the esophagus, throat and voice box.
• Chronic cough
Often this is related to lifestyle and eating habits. Caffeine, spicy food, citrus fruits, alcohol and smoking can elicit reflux. Lying down after eating, stress, and being overweight can also cause reflux. How is the diagnosis of LPR made? An Ear, Nose & Throat (ENT) doctor will examine your larynx (voice box) to look for signs such as swelling, redness and excessive phlegm. A thorough history of your history and dietary habits is also necessary.
• Burning or soreness in the throat • Throat clearing • Excess mucus or phlegm • A bad taste in the mouth • Hoarseness • A sensation of a lump in the throat • Difficulty swallowing Many times, these symptoms can be worse in the morning. Some people with reflux may also experience heartburn, chest pain, or indigestion.
How is LPR treated? LPR is treated with a combination of 3 things: lifestyle changes, dietary control and medication. • Lifestyle changes • Dietary control
• When your symptoms are severe, choose bland food • Reduce stress • Sip only small amounts of fluids during your meals.
• Medication
• Drink more fluid in between meal times
1. Make lifestyle changes
• Make changes to your sleeping patterns:
• Maintain a heathy body weight - losing weight is recommended if you are overweight • Avoid large meals - eat small, frequent meals (about 5-6 per day) • Eat slowly, chew your food well • Eat in a relaxed, calm atmosphere • Do not lie down approximately 3 hours after eating/meals • Avoid physical exercises and straining right after eating • Avoid tight clothing and belts • Reduce or stop smoking • Avoid constipation
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Sleep with the head of your bed elevated 6 to 12 inches (use cinder blocks, wood or bricks under your legs at the head of your bed)
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You can also sleep on 2 to 3 pillows or a foam wedge
2. Use dietary controls The following food can cause discomfort or elicit reflux. It is a good idea to keep a food diary to help you and your doctor plan and decide upon any changes in eating habits you may need. • Tobacco • Caffeine: coffee, tea, chocolate, milo, carbonated beverages • Alcohol: wine, beer, liquor • Spicy food: curry, pepper, chili, hot sauce • Strong-flavoured food: peppers, peppermint, onions, garlic, cinnamon, chocolate • High-fat food: nuts, milk, butter, cream, peanut butter, fried food, cookies, cakes, salad dressing, oil • Citrus fruits and juices: orange, grapefruit, lemon
The following food would not contribute to acid reflux for most people. • Low fat protein food: fish, lean meat, poultry, skim/ low-fat milk, low fat cheese, low-fat yogurt • Carbohydrate food: bread, cereal, crackers, fruits, noodles, potato, rice and vegetables
3. Medication can be prescribed by your doctor If your doctor prescribed you a medication to help control acid reflux, be sure to take them as directed. You should take your medication between 30 minutes to an hour before your meal. Attempt to take your medication at the same time everyday.
Yishun Health is a network of medical institutions and health facilities of the National Healthcare Group. Admiralty Medical Centre • (65) 6807 8000 • www.admiraltymedicalcentre.com.sg Khoo Teck Puat Hospital • (65) 6555 8000 • www.ktph.com.sg Yishun Community Hospital • (65) 6807 8800 • www.yishuncommunityhospital.com.sg The information is correct at the time of printing and subject to revision without further notice.
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