What exactly is
LPR
and
Why it matters to you,
The Singer
What exactly is
LPR
and
Why it matters to you,
The Singer
LPR, three simple letters.
What exactly do they mean?
You probably have heard of reflux, or GERD, before. The most common complaint from individuals with GERD is heartburn or excessive regurgitation or belching. GERD stands for gastroesophageal reflux disease, a condition in which stomach content backflows into the esophagus.
However, LPR is far more than that, and it affects more than you think.
LPR stands for laryngopharyngeal reflux. This medical condition describes the backflow of stomach content beyond the esophagus, eventually splashing into the pharynx (throat) and the larynx (voice box).1,2
The human esophagus consists of two important structures – the upper esophageal sphincter (UES) and the lower esophageal sphincter (LES). They act as valves to keep the stomach content in the stomach. If LES loses its function, the stomach content can find a way back up into the esophagus. With LPR, both UES and LES can no longer keep the stomach content from backflowing.3
The highly acidic stomach content contains gastric acid, pepsin, and undigested food. According to the U.S. National Library of Medicine, gastric acid typically has a pH range of 1.5-3.5; such range is similar to car battery acid. Pepsin is an enzyme that breaks down protein only in acidic environments, a great companion for gastric acid in the stomach.4,5
When the stomach content travels up into the esophagus, then to the pharynx and larynx, gastric acid and pepsin damage – and even destroy – the protective layers (mucosa) along those regions. Without them, these regions are more vulnerable to future damages.
LPR can take place any time during the day or evening. When both the UES and LES lose their functionality, the esophagus essentially becomes an open pipe. If the gastric content continues to splash into the pharynx and the larynx, these regions are affected by the gastric content, resulting in irritation and inflammation.
Symptoms of LPR are vastly different from those of GERD.
Individuals with LPR often experience recurring symptoms, including:1,7,8
hoarseness
excessive mucus in the throat
postnatal drip
sensing a lump in the throat
chronic coughing
laryngitis
bad breath
LPR is often misdiagnosed.
The symptoms of LPR are similar to those in sinus infection, asthma, or nasal allergies. That makes it hard for medical professionals to diagnose correctly.8
In my personal experience, I had to seek advice from multiple ENTs and speech pathologists (SLPs) to finally receive the proper diagnosis and start medically managing the symptom. It is still not an easy downward slope; yet, it becomes much easier once you get the support you need.
This was precisely why I created this website; I want my personal experience to empower YOU to educate and advocate for yourself as a singer. I am here to tell you, “It’s gonna be okay. You got this.”
Read My Story >>
*** Disclaimer ***
This page is only for education purposes.
Please consult a medical professional if you experience any symptoms listed in this article.
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References:
Brown J, Shermetaro C. Laryngopharyngeal Reflux. Treasure Island, FL: StatPearls Publishing, FL; 2021. https://www.ncbi.nlm.nih.gov/books/NBK519548/. Accessed September 28, 2021.
Koufman JA, Aviv JE, Casiano RR, Shaw GY. Laryngopharyngeal Reflux: Position Statement of the Committee on Speech, Voice, and Swallowing Disorders of the American Academy of Otolaryngology-Head and Neck Surgery. Otolaryngology-Head and Neck Surgery. 2002, 127(1), 32–35. DOI: 10.1067/mhn.2002.125760
Jackler R, Lee J, Pau C. Laryngopharyngeal reflux. In Jackler R, Lee J, Pau C, Gralapp C, Chen C, ed. Introductory Textbook of Otolaryngology. Stanford, CA: Stanford Medicine; 2021. https://enttextbook.stanford.edu/chapters/laryngology/laryngopharyngeal-reflux. Accessed October 14, 2021.
Patricia JJ, Dhamoon AS. Physiology, Digestion. Treasure Island, FL: StatPearls Publishing; 2020. https://www.ncbi.nlm.nih.gov/books/NBK544242. Accessed September 28, 2021.
Heda R, Toro F, Tombazzi CR. Physiology, Pepsin. Treasure Island, FL: StatPearls Publishing; 2021. https://www.ncbi.nlm.nih.gov/books/NBK537005. Accessed September 28, 2021.
Koufman JA. The otolaryngologic manifestations of gastroesophageal reflux disease (GERD): a clinical investigation of 225 patients using ambulatory 24-hour pH monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope. 1991; 101(4): 1-78. DOI: 10.1002/lary.1991.101.s53.1
Lechien JR, Huet K, Finck C, Khalife M, Fourneau AF, Delvaux V, Piccaluga M, Harmegnies B, Saussez S. Validity and Reliability of a French Version of Reflux Symptom Index. Journal of Voice. 2017;31(4): 512.e1-512.e7
Karkos PD, Thomas L, Temple R, Issing W. Awareness of General Practitioners towards Treatment of Laryngopharyngeal Reflux: A British Survey. Otolaryngology-Head and Neck Surgery. 2005; 133(4): 505–508.