Once the pepsin is seeded, it leads to a condition with a complex physiology—too complex for PPIs to restore, because they only treat the acid component. A strict low-acid diet may be helpful in nonresponsive patients, according to a recent study of 20 patients with LPR who had failed to respond to twice-daily PPI treatment and H2 block at bedtime Ann Otol Rhinol Laryngol.
The researchers put the patients on a strict low-acid diet for two weeks, in which all foods and beverages with pH levels lower than five were eliminated from the diet. Improvement was seen in 19 people and complete resolution of symptoms in three. Courey approaches the diagnosis more broadly from the get-go. Furthermore, Dr. Courey said 75 percent of his patients are helped by this approach, and have measurable reductions in their reflux symptom index score.
Resolving the problem of how to treat LPR is not easy, and the philosophy on appropriate approaches will probably develop over the next few years. However, without good evidence-based data, finding clear answers will likely take longer than that.
LPR is difficult to confirm, and is often overdiagnosed. Uncertainty of what constitutes abnormal pharyngeal acid exposure. Source: Altman KW, et al. Dietary changes are very efficient in improving LPR symptoms within a short period. Compared to medication and surgery, though, there is less research done into this, simply because there is little money to be made from it. Still, there is at least some research. In one study, participants with LPR followed a low-acid, low-fat diet. Also, many readers are writing me that they get significant and quick results by adjusting what they eat and drink.
This makes sense, as for most people, their eating habits are the most aggravating factor for their reflux. If you bring the causes of your LPR under control, it is just a matter of time before the symptoms will vanish as well. His formal education is in qualitative research. Visit a health professional if these symptoms become evident. When acid reflux leads to persistent heartburn, occurring maybe twice a week for 3 weeks or more, this is known as gastroesophageal reflux disease, or GERD.
Silent reflux, or laryngeal-pharyngeal reflux LPR , is similar, but without the heartburn and indigestion. Many adults manage to control symptoms by adjusting their eating habits and making lifestyle changes. Medications to treat silent reflux, such as antacids, are available over the counter OTC. These can help prevent the acid from returning to the esophagus. Some of these medications are available online. Click here for an excellent range with thousands of customer reviews.
H2-blockers, a form of anti-histamine, might help , especially if a cough bothers the person at night. If antacids do not work, a doctor may prescribe a proton pump inhibitor PPI , such as omeprazole, to reduce stomach acidity. A person with LPR can use these for between 4 weeks and 6 months. Reflux is common in children up to the age of 1 year , and only those who have difficulty feeding or breathing require treatment.
In severe cases, or when another treatment has not been effective, tube feeding and surgery may be necessary. In infants, the muscular valves at the end of the food pipe are not fully developed. These valves keep the contents of the stomach from flowing back into the food pipe.
Adults often have a cold or the flu before they develop LPR. These conditions may make the vocal cords more sensitive to stomach acid.
Certain physical characteristics may make some individuals more likely to develop LPR, including those who have:. Individuals who use their voices frequently and loudly, such as teachers and singers, also face a high risk of developing the condition.
The term Laryngopharyngeal Reflux LPR refers to the backflow of food or stomach acid all of the way back up into the larynx the voice box or the pharynx the throat. Not everyone with reflux has a lot of heartburn or indigestion. In fact, many people with LPR never have heartburn. Because LPR is silent, it is sometimes difficult to diagnose. Some people with LPR do have heartburn. Some people with LPR don't have heartburn very often, but actually about half the people who have LPR never have any heartburn at all.
This is because the material that refluxes does not stay in the esophagus for very long. In other words, the acid does not have enough time to irritate the esophagus and cause heartburn. However, if even small amounts of refluxed material come all the way up into the throat, other problems can occur. This is because compared to the esophagus, the voice box and throat are much more sensitive to injury and irritation from stomach acid.
Also, LPR can sometimes affect a person's breathing and lungs. Chronic hoarseness, throat clearing and cough, as well as a feeling of a lump in the throat or difficulty swallowing, may be signs that you have LPR. Some people have hoarseness that comes and goes, and others have a problem with too much nose and throat drainage, that is, too much mucus or phlegm.
If you have any of these symptoms, and especially if you smoke, you should ask your doctor about LPR.
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