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The Approach to a Patient with Suspected Laryngopharyngeal Reflux Disease (LPRD)

  • Lawrence Borges
  • Thomas L. CarrollEmail author
Chapter

Abstract

Laryngopharyngeal reflux disease (LPR) refers to the symptomatic manifestation of tissue injury that is caused when gastric contents are refluxed retrograde above the level of the upper esophageal sphincter. LPR symptoms can be variable and may include throat symptoms, voice changes, and even disordered swallowing. In addition, LPR symptoms often overlap with other conditions such as other laryngeal pathologies, allergies, and pulmonary disease. This can pose both a diagnostic and therapeutic challenge. In this chapter, we discuss the many ways that LPR may manifest clinically, as well as the common clinical mimickers that should be considered when evaluating a patient with LPR-like symptoms. We then present an overview of the different strategies that are currently available to diagnose LPR – from symptom questionnaires to sophisticated measurement of gastric refluxate – and the relative merits of each. The goal of this chapter is to equip the reader with the knowledge necessary to confidently evaluate the patient with suspected LPR and choose a diagnostic modality that is appropriate for each situation.

Keywords

Laryngopharyngeal reflux (LPR) Reflux Esophagus Throat Voice Swallow Acid Pepsin pH Impedance Manometry 

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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of GastroenterologyBrigham and Women’s HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Division of OtolaryngologyBrigham and Women’s HospitalBostonUSA

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