Laryngopharyngeal Reflux and GERD

Abstract

Since the early 1990s, the consequences of extra-esophageal reflux in the larynx have been recognized to be related to a variety of laryngeal symptoms with certain endoscopic manifestations. The paper by Dr. Koufman described various types of laryngeal injury which were attributed to extra-esophageal reflux also known as laryngopharyngeal reflux (LPR). The mechanism of injury was postulated to be a consequence of acid refluxate as well as from pepsin. Since that time there has been a surge of literature devoted to the topic of LPR seeking to refine its diagnosis, elucidate its pathophysiology, and treat its symptoms and sequelae. Our goal in this chapter is to provide a balanced, evidence-based framework for identifying LPR and providing treatment while balancing the benefits versus the risks of overtreatment and escalating therapy.\nThis review contains 13 figures, 7 tables and 49 references.\nKey Words: LPR, GERD, PPI, RSI, TLESR