Acid Assault: Unmasking the Toll of Laryngopharyngeal Reflux Disease on Vocal Health - A Literature Review.

Laryngopharyngeal reflux disease (LPRD) is characterized by the backflow of gastric contents into the laryngopharynx, distinct from gastroesophageal reflux disease (GERD). Prevalence among otolaryngology patients ranges from 4 to 30% and being the major cause for hoarseness of voice. Common symptoms include hoarseness, chronic coughing, globus sensation, throat clearing and endoscopic evaluation reveals signs like posterior commissure hypertrophy and vocal fold edema. Diagnostic tools such as the Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) aid in assessment, with scores > 13 on RSI and > 7 on RFS indicating LPRD. LPRD significantly contributes to voice disorders, necessitating prompt diagnosis and management. Treatment typically involves proton pump inhibitors (PPIs), leading to symptom improvement within 2-3 months. Understanding the distinct nature of LPRD and its diagnostic criteria is crucial for effective management of this condition. Laryngopharyngeal reflux disease (LPRD) and gastroesophageal reflux disease (GERD) have become epidemics. These diseases are considered to be different entities and therefore present with different symptoms. LPRD, an inflammatory condition which is defined as the regurgitation of gastric contents into the laryngopharynx, where it comes in contact with the tissues of the upper aerodigestive tract. Whereas in GERD, the retrograde flow of contents is restricted to the esophagus. Patients who present with hoarseness for a duration of more than 3 months, the prime causative factor observed is LPRD. Idiopathic hoarseness, chronic coughing, globus sensation, clearing of the throat and choking episodes are the most commonly reported symptoms of LPR (Laryngopharyngeal Reflux). Common signs of LPRD include posterior commissure hypertrophy, vocal fold oedema, hyperaemia, and diffuse laryngeal oedema. Several studies have reported that among patients with voice disorders, LPRD is observed to be a prime factor for their voice change. LPRD can be diagnosed by a simple questionnaire such as Koufman Reflux Symptom Index (KRSI) and Reflux Finding Score (RFS) based on diagnostic evaluation of the larynx by video laryngoscopy. The possibility that the patient is having LPRD is high using these scoring system. Proton pump inhibitors (PPI)s are the mainstay of therapy in LPR. Significant improvement in symptoms have been noted in the patients over a course of few months.