Updates on Laryngo-Pharyngeal Reflux (LPR) and Its Management

Laryngo-pharyngeal reflux (LPR); esophageal reflux; pharyngolaryngeal reflux; or reflux laryngitis refers to the backflow of acid from the stomach to the upper aerodigestive tract of the larynx and pharynx. Repetitive reflux of these contents may lead to LPR. It has been estimated that half of the otolaryngology patients with laryngeal and voice disorders have LPR. The pattern of reflux is different in LPR and gastroesophageal reflux. LPR usually occurs during the daytime in the upright position, whereas gastroesophageal reflux disease more often occurs in the supine position at nighttime or during sleep. Laryngeal edema is an important indicator of LPR that is most often neglected. LPR was previously deemed a controversial topic in laryngology but is now clearer with a better understanding of the pathogenesis. Diagnosis is made based on symptoms, and laryngoscopy aided with investigations and confirmed the response to treatment.