Laryngopharyngeal reflux is an inflammatory disease of the larynx or pharynx that results from the release of gastric acid through the esophagus. Of course, this pathology is an anomaly.
What is the triggering factor causing this disease? What are the symptoms? How is the diagnosis carried out? What are the principles of treatment? Well, all of this should be told now.
About the disease
Near the pharynx and at the beginning of the stomach there is a special muscle ring, also called the sphincter of the esophagus. It protects the larynx and esophagus from the ingestion of gastric juice, enzymes and digested food. Impaired functioning of this ring also causes laryngopharyngeal reflux.
Gastric juice begins to move in the opposite direction. Acid irritates the mucous membrane of the pharynx and larynx, and the posterior airways. And all because of impaired functioning of the muscle ring.
Causes
The list of provoking factors affecting the development of such a pathology as laryngopharyngeal reflux includes:
- Emotional and nervous tension.
- The abuse of coffee, spices, spices and spicy foods.
- Excess weight.
- Pregnancy.
- Bad habits.
- Too active lifestyle, increased physical activity.
- Hard labour.
- Weak muscle.
- The habit is in a prone position.
- Atypically located stomach.
For one or even several of the above reasons, sphincter relaxation usually occurs. As a result, the obstacle that prevented the gastric juice from being thrown back disappears.
Signs of the disease
Of course, this ailment manifests itself. Symptoms of laryngopharyngeal reflux include the following symptoms:
- A cough that does not go away. In this case, there are no symptoms of acute respiratory viral infections.
- Sensation of a lump in the throat that does not go away after swallowing saliva.
- Unreasonable hoarseness of voice.
- Difficulty swallowing.
- Pain and sore throat.
- Dyspnea.
- Pain in the sternum.
- Heaviness after eating.
- Belching and heartburn.
As the disease progresses, other symptoms appear. Arrhythmia may develop or problems associated with the cardiovascular system will be felt. Also, ignoring the symptoms leads to such complications:
- Sores in the throat and larynx, scars.
- Diseases of the trachea and lungs.
- Voice change.
- Malignant neoplasms.
- The defeat of the vocal cords.
Children may have other symptoms. These include noisy breathing, slow weight gain, temporary respiratory arrest (usually in a dream), loss of appetite, and barking cough.
Diagnostics
This topic should also be addressed before proceeding to consider the principles of treatment of laryngopharyngeal reflux. Symptoms and signs listed above are not specific. That is why there are problems with the diagnosis. If the therapist suspects the presence of this ailment, he prescribes the following procedures:
- Examination of the larynx, stomach, throat and esophagus using radiography.
- Determination of acidity in the esophagus.
- Checking the tone of the muscle ring.
A variety of complaints and descriptions led specialists to create detailed questionnaires and tests. The data indicated by patients are the basis for preliminary diagnosis. There is a whole scale of reflux symptoms that makes it clear at what stage the pathology is.
In the event that the symptoms are blurred, the patient is sent for saliva for analysis, during which the level of pepsin is detected. This method is the most sensitive.
Talking about the symptoms and diagnosis of laryngopharyngeal reflux, it should be noted that this ailment is often confused with another disease. They are similar. We are talking about gastroesophageal reflux. But in this case, not only gastric juice is discarded, but also the contents of the stomach.
Therapy
Well, the symptoms of laryngopharyngeal reflux have been described above. And now the treatment is also worth mentioning.
The basis of therapy is H2 blockers and inhibitors, which reduce the acidity of the stomach and the activity of juice production. After the start of therapy, most patients notice an improvement in their condition after 2-3 months. Healing occurs after about six months.
Popular H2 blockers are these drugs:
- "Histodil."
- "Primamet."
- "Cimetidine."
- The Histac.
- Zantak.
- "Ranitidine-Acre."
- Ulceran.
- "Famosan."
- "Famotidine."
- Roxane
The doctor will decide which drug the patient will need to take after the examination and detailed diagnosis. H2-blockers are serious medications that are contraindicated for people with hypersensitivity to the active substance, problems with the kidneys and heart, as well as pathologies of the blood-forming organs.
Prokinetics
After the diagnosis of laryngopharyngeal reflux, in addition to H2-blockers, prokinetics can be prescribed - agents that increase the pressure exerted on the lower part of the esophagus. By the way, they also have other actions:
- Increase the tone of smooth muscles.
- Facilitate the passage of bile.
- Do not allow the relaxation of the body of the stomach.
- Accelerate the passage of food through the esophagus.
- Normalize the motility of the gallbladder.
- Eliminate constipation.
And, of course, prokinetics prevent reflux. As a rule, the administration of such drugs is prescribed:
- "Metoclopramide", "Tserukal", "Raglan".
- "Mosapride", "Mosid", "Mozax".
- Domperidon, Motilak, Motilium.
- "Tsizaprid", "Coordinax", "Peristyl".
All noted drugs (listed in a row are analogues) affect the gastrointestinal motility in their own way. "Metoclopramide" and "Domperidone", for example, affect the motor function of the duodenum, esophagus. And “Cisapride” enhances the contractions of the stomach.
The choice of the optimal drug depends on the mass of factors (stage of the disease, the causes of the disease, individual characteristics of the body). The doctor will recommend the most effective tool.
Sucralfat
This is the name of a gastroprotective drug that is actively used in the treatment of laryngopharyngeal reflux. Sucralfate effectively protects the mucous membranes, and this is important.
It is part of the following pharmaceutical preparations:
- "Venter."
- Keal.
- "Sukrabest."
- Sucralfat-Ratiopharm.
- Sucralfat.
- "Sucras".
- "Sukrat."
- "Soukrafil."
- Ulgastran.
- Alsucral.
- "Andapsin."
- Ankrusal.
After consuming one of these agents, a stable protective film begins to form in the stomach, and Pg synthesis also increases. Pepsin activity at the same time decreases. All drugs are effective in protecting the affected areas of the membrane from aggressive factors.
Antacids
After identifying the causes of laryngopharyngeal reflux, the doctor can also prescribe medications in this group. Antacids are effective drugs that relieve heartburn and neutralize acid. In addition, they reduce excessive pressure in the stomach, remove cramps and prevent reflux of gastric juice.
If we talk about absorbed antacids, then the most popular drugs in this group are Vicalin and Vicair. However, they are rarely prescribed because they penetrate the general bloodstream. But they also get rid of acidity quickly.
Nonabsorbable antacids are more popular. The best medicines of this group are Fosfalugel, Almagel and Maaloks.
The active substances of these drugs are not adsorbed. In addition, they neutralize both hydrochloric acid and bile with pepsin. The effect occurs within 15 minutes, and lasts 2-4 hours.
ethnoscience
Many decide to try the treatment of laryngopharyngeal reflux with folk remedies. A good remedy is a rosehip broth. It should be drunk like regular tea. Every day you need to cook new, fresh. It's simple:
- Take 2 tbsp. l ripe dried berries.
- Pour 1 liter of boiling water.
- Allow 5-6 hours to infuse and cool.
- Drink the entire volume in a day.
Dill is also considered effective. Need 1 tbsp. l dry grated seeds pour a glass of boiling water. Wait 2 hours, strain. Then drink 1 tsp. before eating food.
And many more recommend celery. Its leaves must be passed through a meat grinder to get juice. Then take 1 tbsp. this liquid and pour a glass of clean warm water. This drink is consumed daily in the morning on an empty stomach. You can do the same remedy, but with plantain juice.
An excellent remedy is dandelion syrup. Yellow flowers need to fill a liter jar and generously fill with sugar. Then wait 14 days. During this time, the flowers will let the juice. At the end of the 2nd week, you can drain it into a separate container.
And then use - 1 tsp. dissolve in a glass of warm water and drink before each meal. This effective tool helps with many ailments of the gastrointestinal tract.
Proper nutrition
Of course, with laryngopharyngeal reflux, a diet must be observed. In the first two weeks she is especially strict. Dr. Jamie Kaufman, who is the author of the term for the disease in question, defines the following list of allowed foods:
- Raw or cooked vegetables, excluding garlic, onions and tomatoes.
- Mushrooms, beans and root crops.
- Olive oil as a seasoning (no more than 2 tbsp. L. Per day).
- Crustaceans, mollusks and fish.
- Skinless chicken and turkey meat.
- Light noodle soup.
- Chicken bouillon.
- Squirrels of eggs.
- Whole grain bread and crackers.
- Low-fat muffins without the addition of fruits and berries.
- Bagels.
- Skimmed milk.
- Chamomile tea.
- One cup of coffee per day (preferably with milk).
- Ginger.
- Tofu Cheese.
- Oatmeal and rice porridge.
- Honey.
- Bananas and melon.
Also, a person suffering from laryngopharyngeal reflux is required to change his lifestyle. Here are some general guidelines:
- Stop smoking.
- Stop wearing tight clothes.
- Do not physically load yourself immediately after eating.
- Also do not go to bed after a meal.
- The last meal should be carried out 3-4 hours before the end of the day.
- Sleep with a raised head (on a high pillow, for example).
- Refuse fatty and junk food, sodas, fruit juices, chocolate, peppermint and alcohol.
Following a diet and maintaining the right lifestyle will help to cure laryngopharyngeal reflux faster.
Operation
Finally, it should be noted that the treatment of this pathology can also be surgical. In rare cases, the patient is prescribed laparoscopic fundoplication according to Nissen.
During this operation, the doctor wraps the bottom of the stomach around the lower esophagus. Thus, a cuff is formed - it becomes an obstacle to the reverse flow of contents.
Here are the indications for the intervention:
- Physical inability of the patient to take medication.
- Individual intolerance to medicines prescribed by a doctor.
- Esophageal ulcerative strictures.
- Hernia of the esophagus .
- Abnormal non-acid reflux.
- A highly progressive pathology, accompanied by persistent cough, asthma, aspiration and other extra-esophageal manifestations.
- Insufficiency of the cardiac section of the stomach.
After the intervention, the patient should be in the hospital for 1-3 days. The doctor tells the person individually what needs to be done during the recovery period.