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The truth about acid reflux: Why does it affect 10% of the population?
Laryngolaryngological reflux (LPR) or laryngopharyngeal acid reflux disease (LPRD) affects approximately 10% of the U.S. population. This condition causes the gastric contents to flow back into the throat, pharynx and even nasopharynx, causing various respiratory and laryngeal symptoms. It has been reported that the incidence of LPR can be as high as 50% among patients with voice disorders. This article will explore what LPR is, how it affects your life, and why it has attracted so much attention.
Symptoms of sore throat
Acid reflux in the throat can expose the upper airway to stomach contents, causing a variety of symptoms including hoarseness, postnasal drip, sore throat, and difficulty swallowing.
Some people with LPR experience heartburn, but many have little to no symptoms. This is because the refluxed gastric contents do not stay in the esophagus long enough to cause any significant irritation. For patients with more severe LPR, the short-term presence of gastric contents in the mouth may also cause wear of tooth enamel.
The association between LPR and GERD
LPR is often considered a subtype of gastroesophageal reflux disease (GERD) because it also involves the backflow of stomach contents, but the symptoms are significantly different. Heartburn occurs in more than 80% of GERD cases and in only about 20% of LPR cases. In contrast, dry cough was common in 87% of LPR cases but was seen in less than 5% of GERD cases.
The pathogenesis of acid reflux in the throat may be partly due to the differences in the cell structure of the larynx and the esophagus, which makes the cells in the larynx more susceptible to damage than those in the esophagus.
Diagnosis is difficult
Because the symptoms of LPR are not specific, they can be easily confused with a variety of other diseases, making correct diagnosis difficult. In addition, the overlap with other diseases means that LPR is often underestimated and ineffectively treated. Doctors usually rely on laryngoscopy to detect structural changes and inflammation of the airways to confirm the diagnosis, but these are also nonspecific.
Measuring acid exposure in the throat is considered more effective and can help patients understand whether reflux is actually causing symptoms. Potential biomarkers, such as pepsin, an enzyme produced in the stomach, are also a focus of LPR research. This enzyme remains active in the recovery environment, thus causing ongoing damage to the larynx.
Treatment options
Treatment strategies for LPR often include behavioral and dietary changes. Avoiding stimulant foods such as chocolate, coffee, acidic foods and carbonated drinks, as well as lifestyle changes such as losing weight and quitting smoking, are common recommendations.
Cancer RiskIn terms of drug treatment, proton pump inhibitors (PPIs) are the main drug choice, but their effectiveness for most adults with LPR is still unclear. Many studies have shown that PPIs are less effective than placebo in treating LPR.
People with chronic acid reflux, especially smokers, need to be more aware of their cancer risk. Recent studies have shown that bile reflux may be another factor in laryngeal cancer risk, and bile acids may increase DNA damage in the larynx, making the persistence of LPR not to be ignored.
Future Outlook
Although throat acid reflux has only been known for a short time, as research on related diseases continues to deepen, early diagnosis and treatment strategies are also improving. But even though this small patient group is gaining more attention, the diagnosis and treatment of LPR still requires further scientific validation and clinical practice. This question is worth further consideration: How much more research and effort do we need to find effective treatment options?
