Highlights | Understanding the Disorder | Symptoms | Diagnosis | Treatment | Frontiers
Key Glossary Terms
Voice disorder caused by backflow of stomach fluids to the throat and voice box area; a type of supra-esophageal GERDLaryngopharyngeal Reflux (LPR)
Backflow of stomach fluids to the laryngopharynx (voice box + lower back of throat)
Esophagus or Food Pipe
Muscular “tube” that connects throat to stomach; actively moves swallowed food/drinks into the stomach
Backflow of stomach fluids which contain acid and enzymes
Gastro-Esophageal Reflux Disease (GERD)
Backflow of stomach fluids into the esophagus; associated with heartburn
Evolving Concepts in the Management of Reflux Laryngitis
Investigating the Impact of Stomach Fluid Backflow on Other Voice Disorders
Many otolaryngologists now believe that untreated voice disorders from laryngopharyngeal reflux can contribute to a number of other voice disorders, including non-cancer, pre-cancer, and cancer lesions of the vocal folds. For these reasons, actively managing laryngopharyngeal reflux and reflux laryngitis is important.
Improved Drugs to Reduce Stomach Acid Production – Proton Pump Inhibitors (PPIs)
New research suggests that stronger, longer-lasting medicines to decrease stomach acid production (proton pump inhibitors) can be produced. Such medicines could lead to more effective medical therapy for reflux that fits well with everyday life, thus removing the need for surgery.
Less Invasive Procedures to Reinforce the Lower Food Pipe Sphincter (Lower Esophageal Sphincter, LES)
Currently, Nissen fundoplication and other surgeries require general anesthetic and a brief hospital stay. Researchers are now experimenting with less invasive procedures that could be completed in an outpatient setting and would not require general anesthesia.
Research suggests that radiowave surgery (radiofrequency ablation) can be directed at the lower food pipe sphincter (lower esophageal sphincter) to stiffen it, thus reinforcing it. This added stiffness, or reinforcement, of the LES is intended to improve the barrier against backflowing stomach acid and enzymes.
Some physicians believe that collagen or fat (both natural substances within the body) can be injected into the LES to reinforce it and protect the upper aero-digestive tract against reflux.
The evolution of minimally invasive procedures, such as radio frequency ablation and use of natural injections, makes it likely that the treatment of LPR and reflux laryngitis will change dramatically over the next five years.