Laryngopharyngeal Reflux

How is laryngopharyngeal reflux diagnosed?

A diagnosis of LPR is achieved with a combination of detailed history, physical examination and occasionally some tests. Procedures that may be performed to diagnose this condition include:

• Fibreoptic nasoendoscopy
  A thin scope with a camera attached at the end of it is passed through the nose down to the level of the voice box in the throat under local anaesthesia.
• Barium swallow
  An X-ray test in which you swallow a dye and serial X-rays are taken to assess the dye flow from the oesophagus to stomach. The dye will line the cavity of the oesophagus and stomach and allow detection of large growths. The serial X-rays can also detect acid reflux of the dye into the oesophagus.
• 24-hour pH probe testing
  This procedure is used to evaluate the amount of stomach acid that back-flows into the esophagus and larynx. Two pH sensors (sensors that measure acidity of gastric contents) are used. One is located at the lower end of the oesophagus just above the LES and the other at the upper oesophagus or just above the UES.
• Upper gastrointestinal endoscopy and transnasal oesophagoscopy
  These procedures involve passage of a scope through the mouth or nose, into the oesophagus and stomach. In transnasal oesophagoscopy the scope can be passed through the nose with minimal discomfort and no sedation.
  
  It allows visualisation of infl ammation of the oesophagus due to acid reflux, hiatus hernia which may indicate a weak LES and also abnormal growths in the oesophagus and stomach. A sample can be taken (biopsy) if necessary to exclude cancer or infection.