Don’t Get Lost in the Responsibility Jungle around Laryngopharyngeal Reflux
Some doctors know a lot about laryngopharyngeal reflux (LPR).
However, those doctors are rare – very rare.
Why are there so few doctors who know how to treat LPR, also known as silent reflux?
One reason: there is no one single medical specialization responsible for the treatment.
Laryngopharyngeal reflux lies somewhere in between the different jurisdictions.
Option 1 & 2: ENT or Lung Specialist
Most symptoms show themselves in the ENT area. So most people go to see a doctor who specializes in that.
Some people have asthma-like symptoms or a chronic cough and see a pulmonologist (lung doctor) instead.
The problem: for both specialists, it is very hard to see whether a patient has laryngopharyngeal reflux – or not.
Many doctors have never heard of LPR or silent reflux. That is because the disease has not been recognized by the medical mainstream as a real thing until recently. A doctor who does not stay up to date on the latest research will have no idea what to do with LPR patients.
Many diseases look somewhat like LPR. Allergies can cause similar damage to the mucous membranes. So a lot of doctors just tell patients that’s what they have – allergies or some type of infection.
However, if you really have silent reflux, a treatment against allergies or infections won’t help you.
Option 3: Stomach Specialist
The gastroenterologist (GI) knows more about the actual cause of reflux than the ENT. He specializes in the stomach and connected organs – like the esophagus.
In the end, LPR means something rises up from the stomach when it should not. So the gastroenterologist should be able to help, right?
The problem is: he is only educated about how to treat reflux damages in the areas that he specializes. So he checks whether you have reflux damage in the esophagus. Most people with laryngopharyngeal reflux do not.
The GI can test how much reflux gets into your esophagus. However, some reflux is normal.
Important for us is: how much gets up into our throat? Tiny amounts or reflux in the throat can cause a lot of damage – while they might not affect the esophagus at all. The esophagus is simply much more resistant to reflux damage.
The problem is: the test methods used by gastroenterologists cannot tell you how much reflux gets into the airways.
If your esophagus looks fine, the GI will tell you that you do not have reflux.
As for the problems in your airways, he does not know – he tells you to see an ENT for those.
No Specialty Takes Responsibility for Laryngopharyngeal Reflux (LPR)
However, that is precisely the problem: the ENT tells you to see a gastroenterologist and vice versa.
The ENT sees a problem that he does not know how to treat – because the stomach causes it.
The gastroenterologist does not see the symptoms you have – so he does not know what to do with you either.
We would need someone who specializes in both fields.
Some doctors proactively learn about both fields to treat laryngopharyngeal reflux. Usually, those are ENTs, who supplementally educate themselves about the stomach and esophagus. But they are rare. If you just went to a random specialist, you would be lucky to find one of those few.
Doctors Do Not Have Enough Time for the Patient
Fast tests for silent reflux are very unreliable.
So asking about the symptoms in a very profound way is the key. You need to analyze exactly when reflux happens and how it reacts to different environments and habits.
But that takes time – lots of it.
In most first world countries there is not much time per appointment for the patient.
So they either don’t diagnose laryngopharyngeal reflux at all – or they diagnose it without being very sure about it.
Wrong Diagnosis Causes Unnecessarily Low Life Quality
LPR often stays undiagnosed for a long, long time.
That also means a lot of time passes without getting the proper treatment.
It is not only annoying – it also causes a lot of damage to your body.
Our body has defenses against reflux. But the longer we have reflux, the weaker those barriers get. It is a vicious circle that creates more and more reflux – and makes treatment harder.
Our barriers can regenerate. However, they need a break without reflux for that.
Be the Advocate of Your Own Health
I want to make one thing crystal clear: it is not the doctor’s fault.
There are crazy amounts of diseases out there. You cannot keep up with the latest research for all of them. Medicine gets more and more complicated. A single doctor cannot know everything – even when they already specialize in a certain field.
That is why we ourselves need to become active:
We are the ones that need to navigate through this increasingly complex healthcare system.
We need to find the right doctors who specialize in laryngopharyngeal reflux.
We need to learn about diagnosis instruments and which treatment options exist.
We have to find out what helps us and what doesn’t
Most important: we have to become the advocates for our own health. To help you with that I have written the most extensive guide on LPR online. Click here to go to the article on LPR treatment.