The Difference Between LPR and GERD
Reflux is when liquid comes up from the stomach into the esophagus and causes symptoms. The most common symptoms are heartburn, chest pain, and regurgitation. Some patients have abdominal pain, nausea, vomiting and other GI symptoms as well.
LPR (laryngopharyngeal reflux) is when liquid from the stomach comes all the way up the esophagus and into the back of the throat, irritating the throat, sinuses, and lungs. This can cause an array of symptoms like sinus infections, hoarseness, throat clearing, sore throat, feeling like you have a ball in your throat, pneumonia, and asthma.
We frequently have patients who have had heartburn for years that is tolerable while on medications, but then suddenly develop hoarseness, cough, or sinus infections. This is because the medication reduces the acid; however, for people with LPR, the acid is not the problem. The problem is that valve between the stomach and esophagus is weak and allows fluid to come up into the esophagus. The only thing medications do is make the liquid that comes up less acidic. It takes far less fluid (regardless if the fluid has acid in it or not) to irritate the throat.
There are also patients with LPR who have never had GERD symptoms. They usually present to a pulmonologist or ENT with hoarseness, sore throat, sinus or lung infections, cough, asthma, etc. and are told they have reflux. This can happen because it can only take a small amount of fluid to irritate the throat (again – even if there isn’t any acid in it). The amount is less than what is usually needed to cause GERD symptoms.
Both LPR and GERD are sometimes diagnosed without doing any testing. This can lead to improper treatment as the causes of the symptoms are unknown. We recommend testing for reflux to make sure the appropriate diagnosis and treatment options can be discussed.
To learn more about some of our diagnostic testing options, click here.