Reflux Laryngitis is an inflammation of the laryngeal mucosa caused by gastroesophageal reflux (GER). It is a common condition and accounts for 10% of ENT (ear, nose, and throat) consultations.
Causes of reflux laryngitis
The causes of reflux laryngitis can be attributed to anatomical abnormalities between the stomach and the larynx that facilitate the backward flow of acid, a diet high in acids and fats that increases acidity, unhealthy habits like smoking and alcohol consumption, or poor hygiene practices such as heavy dinners and emotional stress.
It has also been observed to occur more frequently after a viral infection, allergy, or exposure to toxins, where the laryngeal mucosa is already compromised, and gastroesophageal reflux plays an irritating and harmful role, perpetuating damage to the larynx.
“But I don’t experience reflux!”
35% of patients with reflux laryngitis do not exhibit typical GER symptoms (heartburn, burning sensation, retrosternal pain), and their only symptoms are related to the larynx.
What are the symptoms?
The hallmark symptoms of this condition include:
• Chronic irritative cough (worsening at night).
• Voice alterations (predominantly in the mornings).
• Sensation of mucus in the throat.
• Persistent throat clearing.
• Sudden closure of the vocal cords (laryngospasm).
What can I do if I suspect reflux laryngitis?
The diagnosis of reflux laryngitis is made in an ENT specialist’s office and involves a thorough medical history and an examination of the larynx using a fiberoptic scope.
During the fiberoptic examination, the following findings are typically observed:
• Inflammation between the esophagus and the larynx (retrocricoid edema), causing the sensation of throat mucus.
• Inflammation and irritation of the vocal cords, resulting in changes in voice tone and strength.
• Generalized redness of the entire mucosal lining.
• Posterior granulomas.
• Laryngeal stenosis in severe cases.
Digestive tests (pH monitoring, gastroscopy, manometry, etc.) may also be ordered to confirm gastroesophageal reflux, although a high percentage of patients with exclusive laryngeal symptoms typically yield negative results.
How is reflux laryngitis treated?
Treatment is based on dietary and hygienic measures, as well as medical intervention.
Dietary and hygienic measures include:
• Avoiding foods that trigger reflux (fats, alcohol, carbonated beverages, spicy foods, tomatoes, etc.).
• Avoiding heavy meals, especially before bedtime.
• Sleeping with the head elevated at about 30 degrees and refraining from lying down immediately after meals.
• Quitting smoking. • Weight loss if necessary.
Medical treatment involves taking antacids and protectants for the laryngeal and esophageal mucosa for at least 8 weeks, with regular monitoring by the ENT specialist. In advanced stages where damage to the mucosa affects sensory receptors, neuromodulators may be considered.
Is it a serious condition?
The prognosis is good, and treatment is effective when initiated promptly. However, untreated reflux laryngitis can lead to chronic voice problems, airway stenosis, or even an increased risk of laryngeal cancer.