Just before I was due to go on a holiday, I developed a really bad sore throat with a cough which lasted around ten days. While on my holiday, I did what most holiday makers do – I enjoyed eating out and drank more alcohol than I usually do when at home. I let down my hair and succumbed to the holiday spirit, enjoying every bit of it, except the ongoing cough. It concerned me a little that during my two weeks on holiday that my dry, irritated cough kept hanging on and I did not seem to be getting any better. My holiday came to an end, unfortunately the dry cough never improved or went away. It was irregular with no set pattern; coughing at odd times but on a recurrent basis. On top of that, I was having to clear my throat a lot.
It was relentless for five or so weeks, hence I decided to visit a colleague of mine, an Ear Nose & Throat Specialist (ENT) to see why this was persisting. I thought it was possibly a post-nasal drip causing the urge for me to clear my throat and making me cough. However, my colleague identified that what I had was in fact Laryngopharyngeal Reflux (LPR) which is a condition that is completely different to gastroesophageal reflux disease (GERD). The difference is that someone suffering with LPR may not experience the usual burning sensation in the chest (heart burn), making it rather difficult to identify the condition. In fact half of those suffering with LPR actually never experience acid reflux. Acid that is produced in the stomach moves back up the oesophagus or swallow pipe. Instead, the stomach acid backs up, arriving at the pharynx (throat) which in turn, affects the Larynx (voice box). The voice box lining being hypersensitive to this acid reflux, reacts and causes unprotected areas to become inflamed.
To examine my Larynx, the ENT took a look with a rigid endoscope, which has a little camera attached, into my mouth through to the back of my throat. He noticed the vocal folds were swollen and the muscles tightened, a pattern that is linked to LPR. On further questioning, I remembered that when on holiday, my voice quality fluctuated towards the evening. I also awoke every day with a sore throat but I never experienced heartburn. All these are indications of LPR.
The ENT made it clear that the cough was set off by my initial infection, which in turn initiated the LPR and the LPR preserved the cough, repeating the cycle over again. The exotic food and alcoholic consumption during the holiday increased the LPR. He prescribed immediate medication, but because I was swamped with work at the time, my daily intake of the meds was not regular and no surprise, my condition did not really recover. After daily meds for around 10 weeks, diet and lifestyle adjustments, as well as starting a voice therapy program; my dry cough and constant clearing of my throat passed and my voice returned to full health, allowing me to knock back on my meds, and slowly come off them completely.
If you are experiencing any of the symptoms below and they continue, I suggest you visit your GP. If they think it could be LPR, request they refer you to an ENT for further diagnosis. These are some of the symptoms you can experience with LPR:
- coughing (with no infection causing it),
- constant clearing of the throat
- dry throat
- bad taste in your mouth
- feel a “lump’ in your pharynx (throat)
- experience unusual difficulty in swallowing
- changes to the quality of your voice
It is essential that you seek medical advice if you are experiencing any of these symptoms, as untreated LPR can lead to disastrous medical complications including various types of cancer.
The medication for LPR will be prescribed by the GP or ENT, but it is highly advisable to consider seeing a Speech Pathologist for recommendations on diet, lifestyle changes and voice therapy as medication on it’s own often does not make the symptoms completely go away. Extreme cases my require surgery, but this is not common.
If you have any enquiries on Laryngopharyngeal or Acid Reflux please do not hesitate to contact Nikki Martin or call on 0410 777 034 for a consultation. We can also refer you to an ENT should you require this service.