User:VoiceDisordersKristine/sandbox

Laryngopharyngeal reflux - possible changes

Connection to other disorders

Discuss the impact that LPR has in contributing to other health issues. For example, incorporate the connection between LPR and chronic cough, sinusitis and postnasal drip.

Potential source = Airway Reflux

LPR in Pediatrics

Include information on the assessment, symptoms, diagnosis, treatment and influence on other diseases in the pediatric population.

Potential source: LaryngoPharyngeal Reflux in Children

Treatment

Discuss some of the behavioural changes that can be made in order to help with LPR.

Potential source: Therapeutic strategies for laryngeal manifestations of gastroesophageal reflux disease.

Diagnosis

Potential discussion about PH monitoring or biomarkers

 MODIFICATIONS/ADDITIONS TO THE LARYNGOPHARYNGEAL ARTICLE LABELED BY SECITON IT WILL BE ADDED TOO 

** these will be added in to various sections in the article**

Symptoms:

LPR in children and infants tends to manifest with a unique set of symptoms. Common symptoms of LPR in infants include wheezing, stridor, persistent or recurrent cough, apnea, feeding difficulties, aspiration, regurgitation, and failure to thrive. Symptoms seen in children with LPR include a cough, hoarseness, stridor, sore throat, asthma, vomiting, globus sensation, wheezing, aspiration and recurrent pneumonia.

Diagnosis Section:

Additionally, several potential biomarkers of LPR have been investigated. These include inflammatory cytokines, carbonic anyhydrase, E-cadherin and mucins, however their direct implications in LPR are still being established. The presence of Pepsin (enzyme produced in the stomach) in the hypopharynx has also become an increasingly researched biomarker for LPR.

Treatment section:

Dietary modifications may include limiting the intake of chocolate, caffeine, acidic food and liquids, gaseous beverages and foods high in fat. Additional behavioral changes may include cessation of smoking, limiting alcohol consumption and avoiding the ingestion of food shortly before bed. Lifestyle changes in children diagnosed with LPR include dietary modifications to avoid foods that will aggravate reflux (including chocolate, acidic and spicy food, etc), altering positioning (e.g. sleeping on your side), modifying the textures of foods (e.g. thickening feeds to heighten awareness of the passing bolus) and eliminating the intake of food before bed.

Proton Pump inhibitor's are the leading pharmaceutical intervention chosen for the relief and reduction of laryngopharyngeal reflux and they are typically recommended for ongoing use twice a day for a period of 3-6 months.

However, patients should be advised that surgery may not result in complete elimination of LPR symptoms and even with immediate success, recurrence of symptoms later on is still possible.