Laryngopharyngeal Reflux

  • Michele P. Morrison
  • Danielle C. Anderson


Laryngopharyngeal reflux is used to describe laryngeal irritation resulting from contact with gastric secretions. This condition usually presents with vague symptoms including globus (“lump-in-the-throat” sensation), throat clearing, voice alterations, cough, and sore throat. The anatomical structures involved include the larynx, esophagus, and stomach.


Laryngopharyngeal reflux Globus Esophagus Larynx Gastrointestinal tract Gastroesophageal reflux 


  1. 1.
    Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108:308–28.; published online 19 February 2013.CrossRefPubMedGoogle Scholar
  2. 2.
    Irwin RS, Curley FJ, French CL. Chronic cough. The spectrum and frequency of causes, key components of the diagnostic evaluation, and outcome of specific therapy. Am Rev Respir Dis. 1990;141:640–7.CrossRefGoogle Scholar
  3. 3.
    el-Serag HB, Sonnenberg A. Comorbid occurrence of laryngeal or pulmonary disease with esophagitis in United States military veterans. Gastroenterology. 1997;113(3):755–60, ISSN 0016-5085.CrossRefGoogle Scholar
  4. 4.
    Olson NR. Laryngopharyngeal manifestations of gastroesophageal reflux disease. Otolaryngol Clin N Am. 1991;24(5):1201–13. PubMed PMID: 1754220.Google Scholar
  5. 5.
    Ford CN. Evaluation and management of laryngopharyngeal reflux. JAMA. 2005;294(12):1534–40. Scholar
  6. 6.
    Klinkenberg-Knol EC. Otolaryngologic manifestations of gastro-oesophageal reflux disease. Scand J Gastroenterol Suppl. 1998;225:24–8. Review. PubMed PMID: 9515748.CrossRefGoogle Scholar
  7. 7.
    Khan AM, Hashmi SR, Elahi F, Tariq M, Ingrams DR. Laryngopharyngeal reflux: a literature review. Surgeon. 2006;4(4):221–5. Review. PubMed PMID: 16892839.CrossRefGoogle Scholar
  8. 8.
    Modlin IM, Moss SF, Kidd M, Lye KD. Gastroesophageal reflux disease: then and now. J Clin Gastroenterol. 2004;38(5):390–402. Review. PubMed PMID: 15100517.CrossRefGoogle Scholar
  9. 9.
    Stephen J, Sontag MD. Gastroesophageal reflux and asthma. Am J Med. 1997;103(5, Suppl 1):84S–90S, ISSN 0002-9343.Google Scholar
  10. 10.
    Bray GW. The treatment of asthma. Postgrad Med J. 1935;11(120):339–45.CrossRefGoogle Scholar
  11. 11.
    PubMed PMID: 21312974; PubMed Central PMCID: PMC2476505.Google Scholar
  12. 12.
    Winkelstein A. Peptic esophagitis. J Am Med Assoc. 1935;104(11):906–9.CrossRefGoogle Scholar
  13. 13.
    Cherry J, Margulies SI. Contact ulcer of the larynx. Laryngoscope. 1968;78(11):1937–40.CrossRefGoogle Scholar
  14. 14.
    Malcomson KG. Radiological findings in globus hystericus. Br J Radiol. 1966;39(464):583–6.CrossRefGoogle Scholar
  15. 15.
    Lee BE, Kim GH. Globus pharyngeus: a review of its etiology, diagnosis and treatment. World J Gastroenterol: WJG. 2012;18(20):2462–71. Scholar
  16. 16.
    Malcomson K. Globus hystericus vel pharyngis: a reconnaissance of proximal vagal modalities. J Laryngol Otol. 1968;82(3):219–30. Scholar
  17. 17.
    Delahunty JE, Cherry J. Experimentally produced vocal cord granulomas. Laryngoscope. 1968;78(11):1941–7. PubMed PMID: 5722897.CrossRefGoogle Scholar
  18. 18.
    Little FB, Koufman JA, Kohut RI, Marshall RB. Effect of gastric acid on the pathogenesis of subglottic stenosis. Ann Otol Rhinol Laryngol. 1985;94(5 Pt 1):516–9. PubMed PMID: 4051410.CrossRefGoogle Scholar
  19. 19.
    Adhami T, Goldblum JR, Richter JE, Vaezi MF. The role of gastric and duodenal agents in laryngeal injury: an experimental canine model. Am J Gastroenterol. 2004;99(11):2098–106. PubMed PMID: 15554987.CrossRefGoogle Scholar
  20. 20.
    Johnson LF, Demeester TR. Twenty-four-hour pH monitoring of the distal esophagus. A quantitative measure of gastroesophageal reflux. Am J Gastroenterol. 1974;62(4):325–32. PubMed PMID: 4432845.PubMedGoogle Scholar
  21. 21.
    Wiener GJ, Koufman JA, Wu WC, Cooper JB, Richter JE, Castell DO. Chronic hoarseness secondary to gastroesophageal reflux disease: documentation with 24-h ambulatory pH monitoring. Am J Gastroenterol. 1989;84(12):1503–8. PubMed PMID: 2596451.PubMedGoogle Scholar
  22. 22.
    DeMeester TR, Bonavina L, Iascone C, Courtney JV, Skinner DB. Chronic respiratory symptoms and occult gastroesophageal reflux. A prospective clinical study and results of surgical therapy. Ann Surg. 1990;211(3):337–45. PubMed PMID: 2310240; PubMed Central PMCID: PMC1358440.CrossRefGoogle Scholar
  23. 23.
    Kamel PL, Hanson D, Kahrilas PJ. Omeprazole for the treatment of posterior laryngitis. Am J Med. 1994;96(4):321–6, ISSN 0002-9343. Scholar
  24. 24.
    Little JP, Matthews BL, Glock MS, Koufman JA, Reboussin DM, Loughlin CJ, McGuirt WF Jr. Extraesophageal pediatric reflux: 24-hour double-probe pH monitoring of 222 children. Ann Otol Rhinol Laryngol Suppl. 1997;169:1–16. PubMed PMID: 9228867.PubMedGoogle Scholar
  25. 25.
    Hawkins BL. Laryngopharyngeal reflux: a modern day “great masquerader”. J Ky Med Assoc. 1997;95(9):379–85. Review. PubMed PMID: 9322411PubMedGoogle Scholar
  26. 26.
    Koufman J, Sataloff RT, Toohill R. Laryngopharyngeal reflux: consensus conference report. J Voice. 1996;10(3):215–6. PubMed PMID: 8865091.CrossRefGoogle Scholar
  27. 27.
    Johnson J. Bailey’s head and neck surgery: otolaryngology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2013.Google Scholar
  28. 28.
    Marieb EN, Hoehn K. Human anatomy & physiology. San Francisco: Benjamin Cummings; 2010. ISBN 0-8053-9591-1.Google Scholar
  29. 29.
    Czinn SJ, Blanchard SS. 25 – developmental anatomy and physiology of the stomach. In: Wyllie R, Hyams JS, editors. Pediatric gastrointestinal and liver disease (fourth edition). Saint Louis: W.B. Saunders; 2011. p. 262–268.e1. ISBN 9781437707748.Google Scholar
  30. 30.
    Samloff IM. Peptic ulcer: the many proteinases of aggression. Gastroenterology. 1989;96(2 Pt 2 Suppl):586–95. Review. PubMed PMID: 2642445.CrossRefGoogle Scholar
  31. 31.
    Lu W, Liu X, Liu Y-l, Zeng F-f, Wu T, Yang C-l, Shen H-y, Li X-p. Correlation of pepsin-measured laryngopharyngeal reflux disease with symptoms and signs. Otolaryngol Head Neck Surg. 2010;143(6):765–71, ISSN 0194-5998.CrossRefGoogle Scholar
  32. 32.
    Park D, Lee HH, Lee ST, Oh Y, Lee JC, Nam KW, Ryu JS. Normal contractile algorithm of swallowing related muscles revealed by needle EMG and its comparison to videofluoroscopic swallowing study and high resolution manometry studies: a preliminary study. J Electromyogr Kinesiol. 2017;36:81–9. [Epub ahead of print] PubMed PMID: 28763682.CrossRefPubMedGoogle Scholar
  33. 33.
    Kahrilas PJ, Dodds WJ, Dent J, Haeberle B, Hogan WJ, Arndorfer RC. Effect of sleep, spontaneous gastroesophageal reflux, and a meal on upper esophageal sphincter pressure in normal human volunteers. Gastroenterology. 1987;92(2):466–71, ISSN 0016-5085.CrossRefGoogle Scholar
  34. 34.
    Naito Y, Uchiyama K, Kuroda M, Takagi T, Kokura S, Yoshida N, Ichikawa H, Yoshikawa T. Role of pancreatic trypsin in chronic esophagitis induced bygastroduodenal reflux in rats. J Gastroenterol. 2006;41(3):198–208. PubMedPMID: 16699853.CrossRefGoogle Scholar
  35. 35.
    Fitzgerald RC, Onwuegbusi BA, Bajaj-Elliott M, Saeed IT, Burnham WR, Farthing MJ. Diversity in the oesophageal phenotypic response to gastro-oesophageal reflux: immunological determinants. Gut. 2002;50(4):451–9. PubMed PMID: 11889061; PubMed Central PMCID: PMC1773186.CrossRefGoogle Scholar
  36. 36.
    Sasaki CT, Marotta J, Hundal J, Chow J, Eisen RN. Bile-induced laryngitis: is there a basis in evidence? Ann Otol Rhinol Laryngol. 2005;114(3):192–7. PubMed PMID: 15825567.CrossRefGoogle Scholar
  37. 37.
    Cobeta I, Pacheco A, Mora E. The role of the larynx in chronic cough. Acta Otorrinolaringol Esp. 2013;64:363.CrossRefGoogle Scholar
  38. 38.
    Bucca CB, Bugiani M, Culla B, et al. Chronic cough and irritable larynx. J Allergy Clin Immunol. 2011;127:412.CrossRefGoogle Scholar
  39. 39.
    Cook IJ, Dent J, Shannon S, Collins SM. Measurement of upper esophageal sphincter pressure. Effect of acute emotional stress. Gastroenterology. 1987;93(3):526–32. PubMed PMID: 3609662.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Michele P. Morrison
    • 1
  • Danielle C. Anderson
    • 1
  1. 1.Otolaryngology Head & Neck SurgeryNaval Medical Center PortsmouthPortsmouthUSA

Personalised recommendations