Ever find yourself clearing your throat shortly after dinner?
What about after that bucket of KFC last night?
Kh-uugh! Kh-uugh, Kh-uugh!
Or, what about soon after your 64-oz Cola?
Kh-uugh! Kh-uugh, Kh-uugh! Kh-Kh-Kh-uugh!
We surely would not be surprised if your cough in these three different scenarios were all related. The connection? Laryngopharyngeal Reflux Disease. Yup, that’s right – Laryngopharyngeal Reflux disease. For short, we call it LPRD, but you might call it “silent reflux”.
LPRD is a common medical disorder that we see nearly every day in our Ear, Nose, and Throat practice. It occurs when potent stomach acid, which is supposed to stay in the stomach, abnormally rises up the esophagus and spills over onto the voice box. Since the voice box is not designed to see potent stomach acids, voice box tissues become damaged, swollen, and start to not function right.
LPRD symptoms include voice hoarseness, frequent throat clearing, and something called “globus sensation” where patients feel that something is stuck in their throat, but there really isn’t anything there. Other symptoms include typical heartburn, chronic throat irritation, sour taste in the mouth, or difficulty swallowing.
LPRD is easily diagnosed. Most of the time our office uses a flexible camera that we put through your nose so we can look directly at your voice box and surrounding structures. This is performed right in our office and takes about 60-seconds to complete (don’t worry – it’s more pressure than pain). This diagnostic test is helpful because we can look for other things besides LPRD that could be causing your symptoms. However, other tests for LPRD include xrays, barium swallow studies, upper endoscopy, or possibly capsule endoscopy.
If we find LPRD, treatment is straightforward – we aim to reduce stomach acid exposure across the vocal cords. This usually starts with lifestyle changes such as: reducing carbonated beverage intake, reducing caffeine intake, and reducing alcoholic beverage intake. (Sorry, we hope you like milk and water!). Other helpful changes include: eating smaller meals, eat less fatty meals, not eating late at night and going to bed shortly thereafter, reducing spicy food intake, limiting citrus foods, putting the head of the bed up 4-6 degrees, avoiding anti-inflammatory medicines, stop smoking, and losing weight.
Harder said than done, right? In that case, we utilize medicines to help. We typically use acid-blocking medicines such as Prilosec, Nexium, Protonix, Zantac, Pepcid or a combination. These medicines do not prevent acid from reaching the vocal cords, but rather they lower the potency of the acid.
Need a hand with that nagging cough?