Laryngopharyngeal Reflux (LPR)
Silent Reflux Can Cause:
– Trouble swallowing
– Too much throat mucus
– A “lump” in the throat
What is Silent Reflux What is LPR?
The term REFLUX comes from a Greek word that means “backflow,” and it usually refers to “the backflow of stomach contents.” Normally, once the things that we eat reach the stomach, digestion should begin without the content of the stomach coming back up again….refluxing.
The term LARYNGOPHARYNGEAL REFLUX (LPR) refers to the backflow of the food or stomach acid all of the way back up into the larynx. (the voice box) or the pharynx (the throat). LPR can occur during the day or night, even if a person who has LPR hasn’t eaten a thing.
Not everyone with reflux has a lot of heartburn or indigestion. In fact, many people with LPR never have heartburn. This is why LPR is called SILENT REFLUX, and the terms “silent reflux” and “LPR” are often used interchangeably. Because LPR is silent, it is sometimes difficult to diagnose.
Many People with LPR Don’t Have Heartburn… Why is that?
Many people with LPR do have heartburn. Some people with LPR don’t have heartburn very often, but actually about half of people who have LPR never have any heartburn at all. This is because the material that refluxes does not stay in the esophagus for very long.
In other words, the acid does not have enough time to irritate the esophagus and cause heartburn.
However, even when a small amount of refluxed material comes all the way up into the throat, other problems can occur. This is because compared to the esophagus, the voice box and the throat are much more sensitive to injury and irritation from the stomach acid. Also, LPR can sometimes affect a persons breathing and lungs.
How do I know if i have lpr?
Chronic hoarseness, throat clearing, ad cough, as well as a feeling of a lump in the throat or difficulty swallowing may be signs that you have LPR. Some people do have heartburn, too. Some people have hoarseness that comes and goes, and others have a problem with too much nose and throat drainage, that is, too much mucus or phlegm.
If you have any of these symptoms, and especially if you smoke, you should ask your doctor about LPR. The specialist who most often treats people with LPR is the Otolaryngologist (Ear, Nose, and Throat Physician).
If your doctor orders tests, this is to be sure about your diagnosis, to make sure that you don’t have any complications of LPR, and to help pick the best type of treatment for you.
The two most common tests for LPR are pH monitoring, also called pH-metry, and a barium swallow. These two tests are different, and it is common to have both tests done.
The barium swallow is an x-ray test in which you must swallow chalky material that can be seen on the x-rays.
This test shows how you swallow and it shows if there is a narrowing or other abnormality of the throat or the esophagus. It is a good test to evaluate the entire swallowing mechanism.
WHAT IS IT LIKE TO HAVE A Ph-METRY?”
Ph-METRY is a special over-night test that takes about 24-hours to complete. People are not usually admitted to the hospital for this test. PH-metry is used to actually measure acid in your esophagus and throat. Some people say this test is annoying, but it is not painful.
To do this test, you will have a small, soft, flexible tube placed through your nose, which stays in your throat over night. The tube, called a “pH probe,” is connected to a small computer (a box that you wear around your waist) that measures acid in your esophagus and your throat. PH-metry is the best test for LPR, and it can help your doctor determine the best treatment for you.
How is LPR treated?
Treatment for LPR should be individualized, and your doctor will suggest the best treatment for you.
Generally, there are several treatments for LPR:
Changing habits and diet to reduce reflux
Medications to reduce stomach acid, and
Surgery to prevent reflux
Most people with LPR need to modify how and when they eat, as well as take some medication, to get well. Sometimes, nonprescription liquid antacid, such as Maalox, Gelucil, and Mylanta are recommended. When used, these antacids should be taken four times each day – one tablespoon, one hour after each meal, and before bedtime.
Dietary and lifestyle changes alone are not often enough to control LPR – medications that reduce stomach acid are also usually needed. Your doctor must prescribe these.
The Chance to Connect with Other Parents
One of the greatest benefits of the It Takes Two to Talk Program is the opportunity it provides to connect with other parents in similar situations. You’ll have the chance to meet people who really understand what you’re feeling and gain valuable insight by listening to their own experiences using It Takes Two to Talk strategies with their child.
TIPS FOR REDUCING REFLUX AND LPR
Control your LIFE-STYLE and your DIET!
If you use tobacco, QUIT.
Smoking makes you reflux. After every cigarette, you have some LPR.
Don’t wear clothing that is too tight, especially around the waist, (trousers, corsets, belts)
Do not lie down, just after eating…. In fact, do not eat within three hours of bedtime.
You should be on a low-fat diet.
Limit your intake of red meat.
Limit your intake of butter.
Avoid fried foods.
Specifically avoid caffeine (especially coffee and tea), soda pop (especially cola), and mints.
Avoid alcoholic beverages, particularly in the evening.
WILL I NEED LPR TREATMENT FOREVER?
Most patients with LPR require some treatment, most of the time, and some people need medicine all of the time. Some people recover completely for months or years, and then may have a relapse.
In one way, having LPR is a little like having high blood pressure – with treatment, LPR does not usually cause serious medical problems, but without treatment, LPR can be serious, even dangerous.
For people with severe LPR, or people who cannot take reflux medicine, “antireflux” surgery (to restore a new and better stomach valve) may be recommended. In people who have this surgery, most get good relief from LPR for many years.
WHAT KIND OF PROBLEMS CAN LPR CAUSE, AND ARE THEY SERIOUS?
LPR can cause serious problems. LPR can cause noisy breathing, choking episodes, breathing problems (such as asthma or bronchitis), and very uncommonly, cancer of the esophagus, lung, throat, or voice box. (For cancer to develop as a result of LPR, the LPR must be very severe and go untreated for many years.)
CAN CHILDREN GET LPR?
Yes, throat and lung breathing in infants and children can be caused or worsened by LPR. LPR is more difficult to diagnose in children, so that infants and children who may have LPR should be taken to specialist for pH-metry and other tests.
Before going to Clear Speech, my son didn’t understand language receptively nor could he express his feelings in words. He was getting frustrated very easily. Now, our son can understand and has started talking to us about how he feels and what he wants. This makes our daily life a lot easier and less stressful.
My son could not say his “g” and “k” sounds. Melisa Aar has been so fantastic with my son. He is able to say all his sounds now and is more confident when he talks to people. The therapists are so personable here and we would give Miss Melissa 5 stars for being so awesome!
We were looking for supplemental speech for articulation concerns during the summer. Not only did we get help in articulation, but help with his Sensory Processing Disorder. The Safe and Sound Protocol helped in ways I didn’t realize were available through speech therapy. My son’s speech is more intelligible and many of his sensory phobias have dissipated. Clear Speech is great at addressing the child’s needs in the usual ways as well as introducing the newest most innovative therapy treatments available.
Prior to speech therapy at Clear Speech, it was hard for my child to communicate. He also was combative and frustrated. He now is able to speak in sentences and describe what it is if I didn’t understand the first time. He also has more confidence. Lucas is no longer combative. With any child that has delayed speech, you should seek speech therapy and any help before school will be a huge benefit.
When we first joined Clear Speech we had been using the birth to 3 program. Maddie was making some progress but she was still so delayed. Because of her new therapist, Michelle, Maddie has discovered her voice. She is still delayed but able to communicate so much more. Our son, Camden, also has Apraxia and he is becoming better since working with Michelle. It has improved so much. Maddie and Cam are both able to communicate more with us which has greatly helped our day to day lives. We now have tools as parents to help with the two of them and the stress has gone down. Don’t hesitate to seek out speech services. It is never too early to at least have your child evaluated. Once a line of communication is opened between you and your child, it is like a whole new world.
Before I came to Clear Speech therapy my child was not speaking. No
sentences or anything. Life was challenging not just for me but for my
child as well. I noticed my child is now saying more sentences, has
improved eye connection, and is a better listener. I would recommend to
another family that it is very important to get your child into speech
therapy as soon as you can because it’s like a tool, not only for your
child, but it also helps the parent work with your child on speech and
learning to communicate.
Both of my kids had speech delays and would get frustrated due to their lack of language development. Now I can carry on full conversations. They both are a lot more focused! They love coming to their sessions and have had progress in their behavior and attitudes! I would highly recommend Clear Speech to any family needing speech services. The progress I’ve seen in both my children has been amazing since we started coming here! The therapists are so friendly and professional!
My son, Zach, began speech therapy in 2015 with great success. His annunciation became clearer and more understandable in just a year. Once he graduated from speech therapy, he continued on with writing comprehension to further his language understanding. Now, a middle schooler, his writing has improved to grade level and in some cases above level. Thank you Clear Speech therapists! Because we needed help with annunciation and writing, I would recommend their SLPs to any parents whose child could benefit. With their 1:1 ratio, kids get faster results than the SLPs within the school districts as their ratios are higher and sessions are shorter.
Prior to getting therapy at Clear Speech, I noticed my kids had a hard time telling me and others what they needed. They would become very frustrated so most days they had tantrums, they would hit, and when unfamiliar were around they would be very quiet and interact. Our day-to day routines have improved significantly since starting speech therapy. When they couldn’t communicate, we spent hours each day managing their frustrations and trying to understand their needs. Now we can move through our day with little to no frustration. When frustrations do happen, they can use their words to solve the problem. Clear Speech has been a great experience for all three of my children. I recommend to families who need speech therapy to get started as early as possible. Commit to the therapy process and soon you will be able to better connect with your kiddo and hear what they need!
My son has a limited amount of words, was hard to understand when he did
speak, and was sensitive to loud sounds. After starting therapy I can
understand him better, he rarely covers his ears for loud sounds, and has a
larger vocabulary. The most important advice I can give is to follow your
instincts. Our pediatrician did not think my son had a delay, therefore we
did not pursue therapy in a timely fashion. I wish I would have followed my
My daughter’s pediatrician recommended speech therapy services for our two
year old. Although was able to follow directions and understand others, she
wasn’t speaking as much as she should have been. After started services, he
speech has gotten clearer and she seems much more confident talking,
communicating, and identifying. her breath control has gotten better as
well as her tolerance to having her face touched. After the Safe and Sound
Protocol, she has gotten much more patient, willing to share, and follow
directions. Her melt downs from not getting her way are at a minimal as
well as she takes more to time to understand why something is the way it is.
Get a Free Consultation with a Speech Therapist
Get In Touch
Feel free to contact us by phone, fax, email, or standard mail delivery. We try to return communication within 24 hours. If we’re out of the office, attending a conference, or conducting therapy it may take up to 48 hours. We appreciate your patience and look forward to serving you.
Location: 3602 Everett Ave
Everett, WA 98201
Telephone: (425) 785-3342
Fax: (425) 259-6317