Why Is LPR So Difficult to Diagnose?
LPR, Laryngopharyngeal Reflux or Silent Reflux is not a clearly defined condition and there is dispute among doctors as to what exactly LPR is and some even doubt its existence. There is no accepted scientific definition and it can be very difficult to diagnose.
Symptoms associated with LPR are however probably just as common as the heartburn/indigestion types and can be severe enough to blight some patients’ lives.
Because so much remains unknown about LPR and the tests required to make the right diagnosis are not generally available, sufferers have often had the symptoms for a long time and very frustrated at their doctor’s inability to treat them successfully.
What are the symptoms of LPR?
One of the challenges in diagnosing LPR is that there are a very wide range of symptoms:
- Sore throat - sometimes persistent sometimes worse in the morning
- Voice problems - people can report huskiness or weakness of the voice
- Cough; can occur at night or after eating
- Throat clearing/mucous and post-nasal drip
- Globus; otherwise known as a feeling of a lump in the throat
- Sinus problems
- Bad breath
- Nasty taste/tingling lips
Sometimes the diagnosis can be made easily, for instance following an endoscopy. Another challenge in diagnosing LPR is that it may be necessary to perform several tests, tailored to their symptoms, to get a definitive LPR diagnosis.
Some of the possible tests are:
- A Barium swallow x-ray can identify a pharyngeal pouch and a chest x-ray lung disease.
- Naso-Endoscopy; a tiny camera is inserted through the nose to look at the throat and larynx.
- Endoscopy (otherwise known as a gastroscopy) will look at the oesophagus, stomach and duodenum. Both can be undertaken under local anaesthetic or sedation.
- Direct laryngoscopy: This employs a tube called a laryngoscope. This procedure directly visualises of the throat
- Oesophageal physiology tests: these measure oesophageal function
- High Resolution Manometry (HMR) measure pressure
- Impedance reflux test. Measures presence of liquid in the oesophagus, important as sometimes the liquid is not very acidic so patient would fail a traditional acid test.
- Bravo; An alternative to the catheter tests
- SIBO/Intolerance Breath tests, SIBO can cause reflux-like symptoms
- Gastric Emptying Studies – slow gastric emptying can make reflux symptoms worse
If you think you have LPR and need a definitive diagnosis, please contact us at RefluxUK. We are the experts in the UK at diagnosing and treating LPR.
