The feeling of something stuck in the throat is one of the common complaints ENT specialists come across. The reason can be varied, but one of the common reasons for the stuck feeling of the throat is Laryngopharyngeal reflux (LPR).
What is LPR?
When the contents of the stomach traverse all the way up via the esophagus and come out beyond the upper esophageal sphincter, then these stomach contents reflux into the following places:-
- Back of the throat.
- Via the nasopharynx into the nasal airway.
This is known as laryngopharyngeal reflux (LPR).
Symptom of LPR
- Feeling of something stuck in the throat.
- Bitter taste at the back of the throat.
- Burning sensation.
- Hoarseness of voice.
- Difficulty in swallowing.
- Constant clearing of the throat.
- The sensation of drainage from the back of the nose is called a postnasal drip.
- Difficulty in breathing.
- Heartburn.
Causes of LPR
LPR can affect women, men, infants and even children. Causes of LPR include:-
- Malfunctioning or abnormal lower esophageal sphincter muscle (LES).
- Hiatal hernia.
- Abnormal esophageal contractions.
- Slow emptying of the stomach.
- Lifestyle and diet like chocolate, citrus, fatty foods, spices.
- Destructive habits like overeating, alcohol and tobacco abuse.
- Pregnancy.
- Young children may face LPR due to the developmental immaturity of both the esophageal sphincters.
Diagnoses
- Physical examination.
- Patient’s response to a trial of treatment with medication.
- Fibre-optic endoscopic examination.
- Biopsy of the suspected tissue.
- 24-hour pH probe with or without impedance testing.
- Esophageal motility testing (manometry).
- Emptying studies of the stomach.
Treatment
- Lifestyle modification.
- Yoga.
- Exercise.
- Medications like antacids, histamine antagonists, proton pump inhibitors, pro-motility drugs, and foam barrier medications.
- Surgical intervention includes fundoplication if medical management is not helpful.
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