|  | Conditions Treatments | Digestive Health

Extraesophageal Reflux Disease

Extraesophageal reflux disease is another name for laryngopharyngeal reflux disease (LPRD). Unlike gastroesophageal reflux disease, or GERD--which affects the lower esophagus, the tube stretching from your throat to your stomach, bathing it in liquefied stomach contents--LPRD involves both the lower esophagus and the larynx, or voice box, and the throat.

  1. Causes

    • LPRD generally stems from a weakened or loose valve between the esophagus and the stomach, which causes liquefied stomach contents to reflux into the esophagus. The contents generally race quickly through the esophagus and pool in the larynx and throat. Sufferers of GERD generally experience reflux at night, damaging the esophagus, but LPRD sufferers tend to be daytime refluxers, and because the larynx and throat are up to 100 times more sensitive to stomach acid than the esophagus, damage occurs much faster.

    Symptoms

    • LPRD sufferers experience a wide range of symptoms, including hoarseness, excess mucous in the throat, chronic irritation, chronic coughing, and an excessive need to clear the throat. Fewer than 40 percent complain of heartburn. In LPRD, the esophagus is usually only briefly bathed in stomach acid, which pools for a very short time in the larynx and throat.

    Diagnosis

    • In diagnosing LPRD, a physician takes a history of the condition and the present symptoms, followed by a physical examination focusing on the nose and throat, often using a scope to look at the throat. If symptoms are extremely severe, or if treatment is not effective, a doctor may perform a 24-hour pH monitoring test to verify the diagnosis. Usually, only a visual examination is needed.

    Treatment

    • LPRD treatment includes modifying the diet to avoid offending foods that cause and aggravate the reflux, lifestyle changes such as quitting smoking and the consumption of alcohol, and following a regular exercise program. A doctor may prescribe medications such as antacids to counter the overproduction of acid in the stomach. If conservative treatment fails and damage is considerable, surgery to tighten the lower esophageal sphincter muscle, which is the valve that connects the esophagus to the stomach, is an option.

    Prognosis

    • The prognosis for LPRD usually is good, as conservative treatment is usually enough to keep symptoms under control. The condition can be chronic and require some form of medication for life, although if symptoms disappear completely, you may wean yourself offthe medication gradually. Relapses may require taking medication until the symptoms resolve again.

Digestive Health - Related Articles