Lifestyle Management of Silent Reflux (LPR)

Tips for Managing Laryngopharyngeal Reflux

Laryngopharyngeal Reflux, more commonly referred to as LPR, is characterized by the entry of stomach acid and other components into the larynx (voice box) and the pharynx (throat). 

The symptoms include sore throat, hoarseness, persistent need of clearing your throat, coughing, swallowing difficulty and an inflamed larynx.

While the more familiar GERD (gastroesophageal reflux disease) may also contribute to LPR symptoms, there may be other factors at play.

LPR is often referred to as “silent-reflux” because, unlike GERD, it doesn’t present as pain in the chest.

If left untreated it can cause damage in a similar way and is a topic worthy of attention and exploration especially since the larynx and pharynx are more sensitive tissues than the esophagus– which brings us to the content of today’s post.

What’s the best way to manage LPR?

Let’s find out…

The Management Of LPR

As with many other clinical conditions there are three potential areas of intervention with LPR – lifestyle, pharmaceutical and/or surgical.

For today’s post, we will focus on lifestyle management given it falls most within the realm of dietetics.

General guidance for LPR suggests either quitting or minimizing alcohol and cigarette usage.

As per other aspects of lifestyle management, recommendations as per Therapeutic Advances In Chronic Disease  and Stanford Medicine include:

Increasing – Various habits which have the potential to reduce LPR symptoms

• Cardiovascular fitness  (walking, running, swimming, biking etc)
• Duration of time between last bite of food and when you lie down (3 hours or more)
• Duration of time between last bite of food and physical activity (2 hours or more)
• Head elevation while sleeping (4 inch wedge recommended)

Decreasing -  Foods which may irritate the throat lining

• Caffeine
• Chocolate
• Peppermint
• Hot Spices ( curry, hot peppers) & spicy deli meats
• Certain foods such as citrus, kiwi, tomato, pineapple, 
• Carbonated Beverages

Additional Considerations

1. At least one study has demonstrated that professionally delivered acupuncture twice weekly  could improve LPR symptoms.
2. Individuals with LPR may feel the need to clear their throat which could worsen symptoms – drinking some water or swallowing are more advisable. 
3. A 2017 study out of the Journal Of The American Medical Association found that LPR sufferers may gain significant benefits from consuming a more plant-based diet in conjunction with the use of alkaline water.

Final Thoughts

Laryngopharyngeal Reflux does not tend to get the same attention afforded to GERD which could be exasperating for those who are living with it.

Although lifestyle modification may not always be sufficient, it represents a low-risk and worthwhile direction to pursue in those who are willing to make some or all of the changes discussed in today’s article.

While the overall quality of the evidence is not as strong as it could be, there is certainly enough direction provided that, on the whole, the changes discussed are worth pursuing as they generally represent positive lifestyle changes.

I’m hopeful that, alongside the support of your healthcare providers, that the guidance in today’s article might offer you some further relief from what is a painful condition.