Display Patient Information Leaflets

Date issued: February 2025 

For review: February 2027

Ref: C-611/DC/Speech and Language/Managing Laryngopharyngeal Reflux (LPR)

PDF: Managing Laryngopharyngeal Reflux (LPR).pdf [pdf] 184KB

What is Laryngopharyngeal Reflux (LPR)

This is when the contents of the stomach flow back up into the food pipe (oesophagus) and into the throat and voice box. The acid and enzyme (pepsin) in the stomach contents can cause irritation and damage to these areas.

Some Signs of LPR

• Chronic sore throat

• Hoarse voice

• Excessive phlegm

• Frequent throat clearing 

• Dry mouth

• Globus (lump in the throat feeling)

• Chronic or recurrent cough

• Laryngospasm (throat closing over temporarily)

• Poorly controlled asthma

• Sensitive gag reflex

• Heartburn

• Dyspepsia (occasional stomach discomfort)

• Regurgitation (often of a bitter fluid)

Any new symptoms of this nature should always be discussed with your GP.

Sometimes LPR is called ‘Silent Reflux’ because, unlike heartburn or Gastroesophageal Reflux Disease (GORD), there may be no obvious signs.

How is LPR diagnosed?

LPR can be hard to diagnose even with an Ear, Nose and Throat consultant’s examination. Often, it is best diagnosed by a patient’s response to prescribed medications and lifestyle changes.

How to help prevent LPR:

• Stop smoking. Smoking can trigger reflux within 2 minutes of having a cigarette. 

• Reduce or avoid alcohol. 

• Reduce your caffeine intake.

• Eat small, regular meals and try to avoid overeating.

• Leave 3 hours after eating before going to bed.

• Avoid fatty foods like crisps, chocolate, pastry, fried foods, and cheese. 

• Avoid spicy foods or any foods that you notice tend to trigger your reflux.

• Avoid fruit juices and fizzy drinks as these are often acidic.

• Losing weight can help.

• Avoid tight clothing around the waist.

• Avoid bending, exercising, or singing soon after a meal.

• If you get reflux at night-time, try sleeping on your left side, this uses gravity to help keep the stomach contents in.

• Try raising the head of your bed by 4-6 inches (10-15cm) using blocks under the legs of your bed. Again, this helps gravity keep the stomach contents in.  Extra pillows may strain your back and neck and put extra pressure on your stomach if you are not lying flat.

Medications

• Alginate medications, such as Gaviscon Advance®, (available on prescription and over the counter) can be taken after meals and before bed. Alginates form a Barto reduce stomach contents from leaking out of the stomach.

• Your doctor may prescribe a PPI or Proton Pump Inhibitor (e.g. Omeprazole, Lansoprazole, Pantoprazole). These are usually taken twice a day, 30mins before breakfast and supper, 12hrs apart to provide 24-hour cover.

• PPI medications reduce the amount of acid that your stomach produces.

• You may need to try different medications to find the one that suits you. Consult your GP if you have any side-effects and/or break-through reflux events.

• It is important not to stop taking PPI’s suddenly as you may get a ‘rebound’ effect with more severe reflux. Your GP can advise you how to step down this medication.