about laryngopharyngeal reflux

RMacLean
March 2005

When refluxed material comes all the way up the esophagus, past the upper esophageal sphincter (UES) at the top of the esophagus and into the throat it's referred to as Laryngopharyngeal Reflux or LPR. The throat and back of the nasal passages are particularly delicate and sensitive to the acidic material.

LPR can be more common in infants and children because of the shorter distance the refluxed material needs to travel to reach the throat.

symptoms of lpr

Symptoms of LPR in infants include chronic cough, stridor or noisy breathing, difficulty breathing, asthma and/or other respiratory problems, hoarseness, spitting up or vomiting, feeding problems, apneas, ALTE's, episodes of turning blue, aspiration, and croup.  It's important to note the most common symptom of reflux—spitting or vomiting—does not need to be present, and many not always exist for LPR to be present.

complications of LPR

Constant exposure of the throat and other laryngeal structures to acid can cause long term airway problems, ear infections, hoarseness, and sinusitis.  As well laryngopharyngeal reflux can also cause laryngospasms which occurs when the vocal cords slam shut to prevent aspiration of refluxed material into the windpipe (trachea).  This can be terrifying for the child, as well as the parent because when they close to prevent aspiration, it also prevents air passage and temporarily inhibits breathing.

How is LPR treated?

LPR is treated the same way regular GER is treated.  For more info, visit the treatments page from the Infant Reflux and Pediatric GERD Info link above.

Reviewed By Dave Olson, MD
Fellow, American Academy of Pediatrics
Graduate University of Michigan School of Medicine