LPR occurs when the upper esophageal sphincter (UES) opens and allows reflux to enter the throat. Since the components of the affected area (see the list above) are constructed of softer tissue that the esophagus, the potential for damage is greater from stomach acid and digestive enzymes. And if the reflux is "aspirated," or breathed into the lungs, the risk is increased for one to develop aspiration pneumonia. Other pulmonary problems whish may manifest are coughing, wheezing, asthma (especially adult onset), and interstitial fibrosis (the tissue in the lungs becomes inflamed and/or scarred). Excess acid reaching one's mouth can also lead to the decay of the tooth enamel, gingivitis, halitosis, and waterbrash.



Further complications can include odynophagia and dysphagia. And pharynx symptoms can include laryngitis, hoarseness, soreness, the sensation of a lump in one's throat (globus), and earache due to fluids entering one's Eustachian tubes between the throat and the ear.

Overall symptoms may include the above plus:

- Dysphonia

- Frequent throat clearing

- Post nasal drip

- Spasm of the larynx

- Blockage of the breathing passage

- Swallowed food coming back up

- Difficulty singing, especially the loss of vocal range.

Diagnosis of LPR can be more difficult, due in part to the fact that less than 15% of those affected have the "heartburn" associated with typical GERD symptoms. Your physician or health care provider may do a laryngoscopy to diagnose and evaluate the condition. Please consult him/her as quickly as possible if you experience any of the aforementioned symptoms.

Other testing may include:

- pH testing - two sensors are placed (one on each end of the esophagus) to determine if the reflux is reaching one's upper esophagus and to assess the pH content of the reflux.

- Upper gastrointestinal endoscopy, if one complains of dysphagia or odynophagia

Lifestyle changes:

These are the same as those mentioned in Part 2 of this three-part series.

Medical treatments:

- Antacids - Prescription medications to reduce acid production in the stomach

- the Nissen Fundoplication mentioned in Part 2.

As with treatment of GERD one's physician may recommend one, or a combination, of the treatments cited, depending on the severity of your case. And it is recommended that one seek medical care as quickly as possible, should one experience any of the symptoms described in these articles.

Please remember that Acid Reflux can lead to very serious health issues, including some forms of cancer, if left untreated. So see your physician as often as needed to alleviate this potentially devastating disease.