How does lpr affect the lungs

Ann Thorac Med. Gajanan S. Gaude Prof. Author information Article notes Copyright and License information Disclaimer. Address for correspondence: Dr. Gaude J. Medical College, Belgaum - Karnataka, India. E-mail: moc. Received Nov 23; Accepted Feb This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This article has been cited by other articles in PMC. Abstract Gastroesophageal reflux disease GERD may cause, trigger or exacerbate many pulmonary diseases. Keywords: Gastroesophageal reflux disease, lungs, pulmonary. Open in a separate window.

Figure 1. The following are several contributing factors that weaken or relax the lower esophageal sphincter, making reflux worse: Lifestyle — Use of alcohol or cigarettes, obesity, poor posture slouching. Eating habits — Eating large meals, eating soon before bedtime. Bronchial asthma Reflux asthma syndrome Chronic persistent cough Reflux cough syndrome Chronic bronchitis Pulmonary aspiration complications Lung abscess, bronchiectasis, aspiration pneumonitis Idiopathic pulmonary fibrosis Chronic obstructive pulmonary disease Obstructive sleep apnea syndrome.

Pathogenesis GERD can be a compounding factor in the control of asthma. Figure 2. Clinical Manifestations Many patients with asthma report GERD symptoms, including heartburn, regurgitation and dysphagia. Initial treatment Treatment for people who have symptoms of GERD begins with making lifestyle modifications.

Role of proton pump inhibitors in the management of GERD-related asthma and chronic cough Proton pump inhibitors are the most effective acid-suppression medications available and are the cornerstone of therapy for GERD and other acid-mediated conditions.

Table 2 Treatment of asthma — Randomized controlled studies with proton pump inhibitors published during the last 10 years. NA: Not available;. Improvement in subgroup of patients with nocturnal respiratory symptoms and GERD;. Other respiratory problems Unlike asthma and cough, in which the esophago-bronchial reflex may play an important role, direct aspiration of gastric contents into the lung is thought to be the major patho-physiological mechanism in other respiratory disorders.

Figure 3. Approach to diagnosing and managing GERD-related extra-esophageal symptoms. References 1. Jaspersen D. Extraesophageal disorders in gastroesophageal reflux disease.

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That is why most LPR patients develop hoarseness sooner or later. Often it is the first symptom they show. Multiple experts I have interviewed were convinced that reflux is the reason why the number of asthmatics has increased in recent years. According to Dr. Jamie Koufman from the voice institute of New York, it is extremely important to examine whether asthmatics have difficulty breathing in or out. Problems with exhalation are a typical sign of normal asthma, while problems with inhalation indicate laryngopharyngeal reflux.

The constant irritation and inflammation of the mucous membranes leading to increased secretion of mucus. Like during a cold, the constant irritation and the excess mucus triggers a host of other symptoms. Throat clearing is one of them. Like with throat-clearing, the cough is a reaction to the overproduction of mucus. If LPR causes inflammation of your sinuses or nasal cavities, mucus production is increased there as well. All that mucus has to go somewhere. Usually, it will drip down the back of your throat which is called a post-nasal drip.

Some of those affected with LPR report that they feel like they have a lump in their throat. Or a feeling of tightness. It might feel like something is stuck there.

The reason can be LPR. The throat can swell which causes this lump-like feeling. Another reason is that the valve between the esophagus and the throat becomes stressed and tense from reflux. It tries to press together as hard as it can to limit the reflux. This causes the lump-like feeling. You can still get the other LPR symptoms despite that.

Even if the valve presses hard, it cannot block all the gaseous reflux. In medicine, this lump-like feeling is called g lobus syndrome. However, if even small amounts of refluxed material come all the way up into the throat, other problems can occur.

This is because compared to the esophagus, the voice box and throat are much more sensitive to injury and irritation from stomach acid.

Also, LPR can sometimes affect a person's breathing and lungs. Chronic hoarseness, throat clearing and cough, as well as a feeling of a lump in the throat or difficulty swallowing, may be signs that you have LPR. Some people have hoarseness that comes and goes, and others have a problem with too much nose and throat drainage, that is, too much mucus or phlegm.

If you have any of these symptoms, and especially if you smoke, you should ask your doctor about LPR. If your doctor thinks that you could have LPR, he or she will probably perform a throat exam first and look at the voice box and the lower throat. At that point, your doctor may order some tests or recommend specific treatment.

If your doctor orders tests, this is to be sure about your diagnosis, to make sure that you don't have any complications of LPR, and to help pick the best type of treatment for you. These two tests are different, and it is common to have both tests done.

The barium swallow is an xray test in which you must swallow chalky material that can be seen on the xrays. This test shows how you swallow and it shows if there is a narrowing or other abnormality of the throat or esophagus. It is a good test to evaluate the entire swallowing mechanism. People are not usually admitted to the hospital for this test. Some people say this test is annoying, but it is not painful. To do this test, you will have a small, soft, flexible tube placed through your nose, which stays in your throat overnight.

The tube, called a "pH probe," is connected to a small computer a box that you wear around your waist that measures acid in your esophagus and in your throat. Treatment for LPR should be individualized, and your doctor will suggest the best treatment for you. Generally there are several treatments for LPR:.