Laryngopharyngeal Reflux - Diagnosis

Diagnosis

As there are multiple potential etiologies for the respiratory and laryngeal symptoms, establishing LPR as the cause based on symptoms alone is unreliable. Laryngoscopic findings such as erythema, edema, laryngeal granulomas, and interarytenoid hypertrophy have been used to establish the diagnosis; but these findings are very nonspecific, and have been described in the majority of asymptomatic subjects undergoing laryngoscopy. Response to acid-suppression therapy has been suggested as a diagnostic tool for confirming diagnosis of LPR, but studies have shown that the response to empirical trials of such therapy (as with proton-pump inhibitors) in these patients is often disappointing. Several studies have emphasized the importance of measuring proximal esophageal, or, ideally, pharyngeal acid exposure in patients with clinical symptoms of LPR, to document reflux as the cause of the symptoms.

Before a diagnosis can be made, the doctor will need to record the patient’s medical history and may ask for details about the symptoms that the patient is experiencing. The doctor will then need to perform a physical examination with particular concentration around the head and neck. The doctor may need to use a specialized camera lens made of fiber optic strands. This is gently fed down the patient’s throat which then feeds back images to a monitor. This enables the doctor to get a clearer look at the throat, particularly the larynx. Tell-tale signs include redness, swelling, and obvious irritation. Once a diagnosis is made, the doctor will propose a treatment method.