Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) are reflux conditions. GERD causes discomfort in the esophagus, while LPR affects the throat.

The regurgitation of acidic stomach contents characterizes both GERD and LPR. However, the conditions differ in their symptoms and the areas involved.

In GERD, acid reflux affects the esophagus, causing heartburn — an uncomfortable burning sensation in the chest. In contrast, LPR triggers atypical respiratory and throat symptoms. It happens as gastric acid backflows into and then past the esophagus into the larynx.

This article explores LPR vs. GERD, their similarities and differences.

Person having teaShare on Pinterest
MoMo Productions/Getty Images

LPR and GERD are both forms of acid reflux. However, the symptoms of LPR and GERD are dissimilar. GERD causes heartburn and chest discomfort, but LPR may not cause such symptoms.

For this reason, doctors may refer to LPR as silent reflux. However, it may cause symptoms that resemble a cold or allergies, such as a chronic cough or sore throat.

GERD and LPR occur when sphincters fail to prevent the reflux of gastric acid and stomach enzymes.

As a result, both GERD and LPR can cause discomfort, inflammation, and tissue damage in their respective affected areas, whether the esophagus or the upper airways.

Furthermore, lifestyle factors, such as obesity, smoking, and dietary habits, can exacerbate both conditions. Adopting healthier eating patterns, weight management, and avoiding triggers, such as spicy foods, caffeine, and alcohol, may benefit both conditions.

Despite sharing the common origin of reflux, GERD and LPR differ significantly in their symptoms and anatomical involvement.

GERD primarily affects the esophagus and involves the LES. It causes symptoms of heartburn and regurgitation. In contrast, LPR involves the UES and impacts the upper airways and throat, giving rise to atypical respiratory and laryngeal symptoms.

GERD is a chronic condition affecting the lower esophageal sphincter (LES), a muscular ring that separates the esophagus from the stomach.

Typically, the LES prevents stomach contents from flowing back into the esophagus. However, in GERD, the LES weakens or relaxes inappropriately, allowing gastric acid and digestive enzymes to reflux, or backflow, into the esophagus. This leads to irritation and inflammation of the esophageal lining, resulting in various symptoms.

Common symptoms of GERD include:

  • a burning sensation in the chest or throat
  • regurgitation of stomach contents into the throat
  • an acidic, unpleasant taste in the mouth
  • difficulty swallowing
  • nausea

Lifestyle factors, such as obesity, smoking, and certain dietary choices, can exacerbate GERD symptoms. Long-term, untreated GERD can lead to complications, such as esophagitis, Barrett’s esophagus, and an increase in the risk of esophageal cancer.

Unlike GERD, LPR involves the backflow of stomach contents into the upper airways, larynx, and pharynx rather than only the esophagus. It arises due to a malfunctioning upper esophageal sphincter (UES) or inadequate coordination between the UES and the larynx during swallowing.

LPR often presents with a diverse array of symptoms, which can include:

Additionally, individuals with LPR may experience asthma-like symptoms and difficulty breathing. The acidic and enzymatic content of the reflux can cause irritation and inflammation of the upper airways, leading to these characteristic respiratory symptoms.

If an individual experiences symptoms of LPR or GERD, they should seek prompt medical attention.

A person should note their symptoms, duration, and any accompanying discomfort to help the doctor with their diagnosis. They should also inform the doctor of their medical history, lifestyle factors, and current medications or supplements.

The doctor may conduct a thorough physical examination and recommend further tests to confirm the diagnosis and rule out other conditions. They can then provide timely and appropriate treatment to manage symptoms effectively and prevent potential complications.

Acid reflux causes both GERD and LPR.

In GERD, the LES weakens, leading to the backflow of gastric acid and enzymes into the esophagus. Common triggers for GERD include certain foods, lifestyle factors, and certain medications that can relax the LES.

Conversely, LPR occurs when the UES fails to function adequately, allowing stomach contents to reach beyond the esophagus and into the upper airways and larynx. Factors, such as diet, smoking, alcohol consumption, and obesity, can contribute to its development.

LPR treatment aims to reduce the pressure on the UES, reducing acid production along with alleviating symptoms, reducing throat irritation, and preventing potential complications.

Medical therapy for LPR may involve proton pump inhibitors (PPIs) or H2 receptor antagonists. These medications help reduce gastric acid production and alleviate throat irritation.

Lifestyle modifications, such as quitting smoking and limiting alcohol consumption, are also essential in reducing LPR symptoms.

Behavioral changes can help minimize nighttime reflux episodes. This may involve elevating the head of the bed while sleeping and avoiding eating close to bedtime.

Treatment for GERD also centers around lifestyle modifications and medications to reduce gastric acid production. Antacids may also provide on-demand relief of occasional symptoms.

For individuals with severe GERD or those who do not respond adequately to medication, surgery is an option. Nissen fundoplication is a standard surgical procedure that reinforces the LES to prevent reflux. Endoscopic procedures, such as radiofrequency ablation, offer less invasive alternatives to traditional surgery.

Gastroesophageal reflux disease and laryngopharyngeal reflux are distinct yet related conditions involving the backward flow of stomach acid. While they share common causes, such as lifestyle factors and sphincter dysfunction, they cause different symptoms.

GERD primarily causes heartburn and chest discomfort. However, in LPR, the acid travels through the esophagus and into the throat, causing throat and airway symptoms.

Treatment for both conditions involves lifestyle changes and medications that block acid production.