LPR and GERD-The difference

I was asked today what the difference was between Gastroeosphogeal Reflux(GERD) and Laryngopharyngeal reflux (LPR). This is a presentation I gave some years ago which explains it.
LPR is probably one of the commonest presentations to our clinic and if a good history is taken can be treated initially without referral. Many patients have a fear of 'throat cancer' but with simple advice and treatment can be reassured. If a patient complains of 'TRUE' dysphagia they should certainly be referred immediately.

Laryngopharyngeal Reflux from jeremygathercole

Laryngopharyngeal reflux (LPR)

Laryngopharyngeal reflux(LPR) is one of the common presentations to our clinic. We probably see a patient with this diagnosis every single clinic.

A patient may have some or all of the following symptoms:

• Hoarseness
• Chronic (ongoing) cough
• Frequent throat clearing
• Constant mucus or phelgm in the throat
• Dry or sandpaper like sensation in the throat
• Pain or burning sensation in the throat
• Feeling of a lump in the throat (globus pharyngeus)
• Problems swallowing
• Bad/bitter taste in the mouth (especially in morning)
• Asthma-like symptoms
• Ear pain and/or persistent ear infections
• Post-nasal drip
• Large lingual tonsils

Note that these symptoms are not the same as GERD, with little heartburn and reflux. 
This condition was not taught to us when I was a student and patients would often be labelled as stressed.(Globus Hystericus). Because we now know that reflux is the trigger it is usually relatively easy to treat with proton pump inhibitors.


 It is important though to exclude other more serious pathologies by performing a flexible endoscopic examination. Many patients have the fear of cancer and are reassured by examination.