Laryngopharyngeal reflux

Question 1

What is Laryngopharyngeal reflux?

Answer 1

A condition caused by gastro-oesophageal reflux resulting in inflammatory changes to the larynx/hypopharynx mucosa

Question 2

What does Laryngopharyngeal reflux result in?

Answer 2

Inflammatory changes to the larynx/hypopharynx mucosa

Question 3

What are the main feature of laryngopharyngeal reflux?

Answer 3

the sensation of a lump in the throat - ‘globus’
hoarseness
chronic cough
dysphagia
heartburn

Question 4

How does the sensation of a lump in the throat - ‘globus’ present in someone with laryngopharyngeal reflux?

Answer 4

typically felt in the midline
typically worse when swallowing saliva rather than eating or drinking

Question 5

What might you find on examination of someone with Laryngopharyngeal reflux?

Answer 5

external examination of the neck should be normal- no masses
posterior pharynx may appear erythematous

Question 6

How might the posterior pharynx appear in someone with laryngopharyngeal reflux?

Answer 6

Erythematous

Question 7

When can someone be diagnosed with Laryngopharyngeal reflux
?

Answer 7

In the absence of red flags a clinical diagnosis of LPR can be made without further investigations

Question 8

What are possible reasons why someone might be referred for cancer pathway when presenting with symptoms of Laryngopharyngeal reflux?

Answer 8

persistent, unilateral throat discomfort
dysphagia, odynophagia (i.e. with food rather than just saliva)
persistent hoarseness

Question 9

What is the management of someone with laryngopharyngeal reflux?

Answer 9

lifestyle measures
proton pump inhibitor
sodium alginate liquids (e.g. Gaviscon)

Question 10

What are possible triggers of laryngopharyngeal reflux?

Answer 10

Fatty foods
Caffeine
Chocolate
Alcohol