If you scour the internet for long enough, you’ll find dozens of possible interventions and treatments for Laryngopharyngeal Reflux. There are many worth considering, and you’re likely to find a lot of different success stories based on a lot of different treatment types. Of course this also makes things pretty confusing. Where are you supposed to start?
In this post, we’ll explore the types of interventions available by category, in the order in which it might make sense to try them – that is from least costly, difficult and invasive to the most extreme. When you decide what your treatment regimen is going to be, you may find it useful to think through these categories. How serious is your case? How urgent is resolution? Have you worked through simpler options before trying more extreme interventions? Hopefully this will serve as food for thought when you assess your treatment options.
Many people skip straight over this type of intervention and it may in fact be sufficient to treat your LPR if there’s no serious underlying condition involved. The reason that behavioural interventions may work for you, is that digestion is closely linked to your hormones and stress levels. If you’re unable to relax, you may not be able to digest, and that can lead to the symptoms of LPR. Most behavioural interventions involve either making food easier to digest or ensuring you’re relaxed enough for your body to digest naturally.
- Chewing more thoroughly
- Not drinking too much water with meals
- Eating 3-4 hours before bed time and not lying down after eating
- Taking deep breaths before eating
- Stress management practices like meditation and deep breathing
- Mark Hyman – 7 Steps To Reverse Acid Reflux
- Dr. Weil – GERD
- Dr. Weil – 4-7-8 Breathing Exercise
- Reflux MD – How Diaphragm Exercises Improve Symptoms
- Huffington Post – Breathing Exercises Could Help Relieve Mild Heartburn
Dietary interventions can also be a great place to start when trying to treat any kind of reflux including LPR. They are actually helpful in a number of scenarios:
- Your LPR may be a reaction to a trigger food, an allergy or an intolerance
- Your LPR may be the result of an underlying pathogen such as:
- Fungal overgrowth
- Bacterial overgrowth
In both instances, some version of an elimination diet can be helpful. For food intolerances, allergies and triggers, an elimination diet can help you identify what those foods are that you should permanently eliminate. If on the other hand, you have an underlying pathogen, eliminating certain types of food can help to starve it. Having said that, elimination of some pathogens may require more aggressive treatments such as those described later in this artcile.
Types of elimination diet
It can be confusing to try to pick among the many types of elimination diet that are claimed to aid people who suffer with various types of reflux, but they broadly fall into the following families:
- Low acid diet
- Low fat diet
- Gluten free diets
- Dairy free diets
- Low FODMAP diet
- Specific Carbohydrate Diet
- GAPs Diet
- SIBO diets
- Fast Tract Diet
- Low Histamine Diet
Most dietary recommendations for treating LPR and reflux more broadly involve one or a combination of the above types of diet. Assessing the effectiveness of each of these types of diet for LPR is beyond the scope of this post, however the general principles are important:
- Try to eliminate possible allergens or common food sensitivities
- Try to reduce the types of foods that feed gut pathogens (mostly carbohydrates)
- Reintroduce foods one at a time so you can clearly determine which may be aggravating your LPR
If diet and behavioural changes don’t help your LPR, some people like to consider natural or herbal interventions before they undertake pharmaceutical ones. Again, it’s difficult to share an assessment of each of these possible treatments, but all of these seem to have at least some support as possible treatments for all types of reflux and LPR specifically.
- Demulcent herbs such as:
- Deglycerized Licorice
- Slippery Elm
- Marshmallow Root
- Manuka Honey
- Digestive Enzymes
- Betaine HCL
- Herbal antimocrobials including:
- Oregano oil
- Thyme oil
- Sage oil
- Combination herbal antimicrobial products such as:
- Candibactin AR
- Candibactin BR
Some of these treatments aim to soothe the symptoms of LPR. Others aim to eliminate pathogens that may be causing LPR. Finally, some of them simply aim to heal the gut and improve digestion.
Most people still turn to pharmaceuticals to help with all kinds of reflux. Pharmaceutical interventions can broadly be classified into over the counter (OTC) and prescription medications.
OTC LPR interventions
Over the counter options in most countries include:
- Antacids such as:
- Raft-forming treatments with sodium alginate (usually also including antacids) such as Gaviscon Dual Action
- H2 Blockers (in some countries these require a prescription)
For those who are really suffering with their LPR, the most serious intervention one can undertake is an operation. The most common operation for both GERD and LPR is the Nissen Fundoplication. This is quite an extreme option, that involves the stomach being surgically tied around the bottom of the oesophagus, effectively making the opening and lower oesophageal sphincter tighter. This is intended to physically stop any refluxate from travelling up the oesophagus.
Generally speaking, only those who have failed to experience any relief with any of the above types of treatments would consider getting a Nissen Fundoplication
- Wikipedia – Nissen Fundoplication
- PubMed – Impact of Nissen fundoplication on laryngopharyngeal reflux symptoms
Which type of intervention is right for you?
Reading about all of these options may leave you wondering where to start. If your symptoms aren’t debilitating, then it might make most sense to work from the top of the list downwards, as it is organised from least to most costly and invasive. However, you should also take into consideration what’s available to you and what type of treatment sounds right for you. Of course, above all, you should consult with medical practitioner, particularly if your symptoms are severe or if you’re considering any of the more significant interventions.