Laryngopharyngeal reflux is different from classic gastroesophageal reflux disease

The patterns, mechanisms, manifestations, and treatment of laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD) differ, and the gastroenterology model of reflux disease does not apply to LPR. LPR patients have head and neck symptoms, but heartburn is uncommon. Consequently, LPR is often called silent reflux. LPR patients have predominantly upright (day-time) reflux and normal esophageal motility; most do not have esophagitis, which is the diagnostic sine qua non of GERD. Moreover, the laryngopharyngeal epithelium is far more susceptible to reflux-related tissue injury than is the esophageal epithelium. Because of these differences, treatment algorithms for LPR and GERD vary.