Laryngopharyngeal reflux disease: Updated examination of mechanisms, pathophysiology, treatment, and association with gastroesophageal reflux disease

Abstract

Laryngopharyngeal reflux disease (LPRD) is an inflammatory condition in the laryngopharynx and upper aerodigestive tract mucosa caused by reflux of stomach contents beyond the esophagus. LPRD commonly presents with sym-ptoms such as hoarseness, cough, sore throat, a feeling of throat obstruction, excessive throat mucus. This complex condition is thought to involve both reflux and reflex mechanisms, but a clear understanding of its molecular mechanisms is still lacking. Currently, there is no standardized diagnosis or treatment protocol. Therapeutic strategies for LPRD mainly include lifestyle modifications, proton pump inhibitors and endoscopic surgery. This paper seeks to provide a comprehensive overview of the existing literature regarding the mechanisms, patho-physiology and treatment of LPRD. We also provide an in-depth exploration of the association between LPRD and gastroesophageal reflux disease.

Keywords: Laryngopharyngeal reflux; Gastroesophageal reflux; Head neck surgery; Laryngitis; Otolaryngology

Core Tip: The pathological mechanism underlying laryngopharyngeal reflux disease (LPRD) is still unclear. There is still a lack of unified standards for the diagnosis of LPRD. Comprehensive evaluation of multiple diagnostic methods is the most reasonable choice, and help clinician to systematically establish personalized treatment options, ranging from lifestyle/diet changes, to medication, and possibly even surgery. LPRD may be pathogenically associated with gastroesophageal reflux disease. As our ability to understand LPRD, and diagnose and classify patients on the basis of diagnostic tests improves, we hope to develop a more simplified approach to treat these patients.