The Differences between Gastroesophageal and Laryngopharyngeal Reflux

Abstract

Gastroesophageal reflux (GER) and laryngopharyngeal reflux (LPR) have different pathophysiological mechanisms of occurrence and are characterized by different clinical pictures and symptomatology. In clinical practice, it often happens that LPR remains unrecognized or is defined as atypical gastroesophageal reflux, thus, it is necessary to distinguish between these two clinical entities. Laryngopharyngeal reflux refers to the return of gastric contents from the stomach through the esophagus to the larynx, pharynx, paranasal cavities, middle ear, and lower respiratory tract, and it is part of the wider extraesophageal reflux syndrome (EER). Extraesophageal symptoms are common in GERD, and studies show an increasing prevalence of LPR in patients with GERD, as well as an association of reflux disease with cough and dysphonia symptoms. The aim of the chapter is to describe differences between GER and LPR in order to facilitate the recognition and differentiation of manifest and latent symptoms, diagnosis, and choice of therapeutic approach.