what type of doctor to treat silent reflux

Laryngopharyngeal Reflux (Silent Reflux)

Medically Reviewed by Jennifer Robinson, MD on April 25, 2020

Laryngopharyngeal reflux (LPR) is similar to another condition -- GERD -- that results from the contents of the stomach backing up (reflux). But the symptoms of LPR are oft different than those that are typical of gastroesophageal reflux illness (GERD).

With LPR, y'all may non accept the classic symptoms of GERD, such equally a burning awareness in your lower breast (heartburn). That's why it can be difficult to diagnose and why it is sometimes called silent reflux.

Causes of LPR

At either cease of your esophagus is a ring of musculus (sphincter). Normally, these sphincters go along the contents of your stomach where they belong -- in your stomach. Just with LPR, the sphincters don't work correct. Stomach acrid backs up into the back of your throat (throat) or voice box (larynx), or fifty-fifty into the back of your nasal airway. It tin cause inflammation in areas that are non protected against gastric acrid exposure.

Silent reflux is common in infants because their sphincters are undeveloped, they have a shorter esophagus, and they lie down much of the fourth dimension. The cause in adults is not known.

Symptoms of LPR

Symptoms in infants and children may include:

• Hoarseness
• "Barking" or chronic cough
• Reactive airway illness (asthma)
• Noisy breathing or pauses in breathing (apnea)
• Problem feeding, spitting up, or inhaling food
• Problem gaining weight

With LPR, adults may accept heartburn or a biting taste or burning awareness in the back of the throat. But they are less likely to have such classic signs of GERD. More oftentimes, symptoms in adults are vague and may be easily confused with other problems. The most common symptoms include:

• Excessive throat clearing
• Persistent cough
• Hoarseness
• A "lump" in the throat that doesn't become abroad with repeated swallowing

Other symptoms may include:

• A sensation of postnasal drip or excess pharynx mucus
• Trouble swallowing
• Trouble animate
• Sore throat

Complications of LPR

Tum acid that pools in the throat and larynx can cause long-term irritation and harm. Without treatment, it can be serious.

In infants and children, LPR can cause:

• Narrowing of the area beneath the vocal cords
• Contact ulcers
• Recurrent ear infections from problems with eustachian tube role
• Lasting buildup of middle ear fluid

In adults, silent reflux can scar the throat and voice box. It can too increase adventure for cancer in the area, impact the lungs, and may irritate atmospheric condition such as asthma, emphysema, or bronchitis.

Diagnosis of LPR

Although silent reflux is harder to diagnose than GERD, a doctor can diagnose it through a combination of a medical history, physical test, and one or more tests. Tests may include:

• An endoscopic examination, an office procedure that involves viewing the throat and vocal cords with a flexible or rigid viewing instrument
• pH monitoring, which involves placing a pocket-sized catheter through the nose and into the throat and esophagus; hither, sensors observe acid, and a modest figurer worn at the waist records findings during a 24-60 minutes period. Newer pH probes placed in the back of your pharynx or capsules placed higher up in the esophagus may be used to meliorate place reflux.

Treatment of LPR

Silent reflux treatment for infants and children may include:

• Smaller and more frequent feedings
• Keeping an baby in a vertical position for at least xxx minutes later on feeding
• Medications such every bit H2 blockers or proton pump inhibitors, as directed by the pediatrician
• Surgery for any abnormalities that can't be treated in other ways

Silent reflux treatment for adults may include these lifestyle modifications:

• Lose weight, if needed.
• Quit smoking, if you are a smoker.
• Avert alcohol.
• Restrict chocolate, mints, fats, citrus fruits, carbonated beverages, spicy or tomato-based products, red wine, and caffeine.
• Stop eating at least iii hours before going to bed.
• Elevate the caput of the bed nigh four to 6 inches.
• Avert wearing tight-fitting clothes effectually the waist.
• Try chewing gum to increment saliva and neutralize acid.

You may also need to accept one or more than types of medicine such every bit:

• Proton pump inhibitors such asdexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), omeprazole, or rabeprazole (Aciphex), and sodium bicarbonate (Zegerid) to reduce gastric acid.
• H2 blockers such every bit cimetidine (Tagamet), famotidine (Pepcid), or nnizatidine to reduce gastric acid.
• Prokinetic agents to increment the frontwards movement of the GI tract and increase the pressure of the lower esophageal sphincter. These medications are non every bit commonly used, because they accept been linked to adverse effects on heart rhythm and diarrhea.
• Sucralfate to help protect injured mucous membranes.
• Antacids to help neutralize acrid; these are used more commonly for symptoms of heartburn.

Some people respond well to self-care and medical management. However, others need more ambitious and lengthy treatment. If this is not effective or if symptoms recur, your md may suggest surgery.

Fundoplication is a type of surgery which involves wrapping the upper role of the breadbasket around the lower esophagus to create a stronger valve between the esophagus and tummy. It is commonly done laparoscopically, with small-scale surgical incisions and use of small surgical equipment and a laparoscope to help the surgeon meet inside. Fundoplication tin also be done equally a traditional open surgery with a larger incision.

Other techniques can also be done laparoscopically, including placing a band of titanium beads around the outside of the lower esophagus that strengthens the valve while still letting nutrient laissez passer through.

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Source: https://www.webmd.com/heartburn-gerd/guide/laryngopharyngeal-reflux-silent-reflux

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