**3. There are several related reflux conditions**

Esophagitis is aggravated by acidic reflux and several other conditions are also caused by this condition. All except esophagitis have similar characteristics and treatments.

Reflux is a condition in which stomach acids sometimes bubble up from the stomach, through the oesophagus and into throat, larynx and pharynx. The effect of these acids is to cause the symptoms [14] of:

Heartburn Burning sensation in the chest Acidic reflux Swallowing difficulties Feeling of a lump in the throat Feeling of a blockage in the chest when eating Chest pains Pain under the breastbone (sternum) Stomach pains before eating Stomach pains after eating Reduced appetite Early 'Full up' feeling Feeling sick Constipated, gassy Vomiting Persistent dry or phlegmy cough Food or drink 'goes down the wrong way' Hoarseness Breathing difficulties

It should be noted that if some of the above symptoms are chronic, and especially if they do not respond to medication, they could be caused by cancer or other diseases and these should be considered before diagnosing reflux as the sole cause.

Refluxing stomach acids is the underlying cause of several conditions: LPR, GERD (or GORD), Silent Reflux, IED. These conditions are sometimes known by their full names: Laryngopharyngeal Reflux, Gastroesophageal Reflux Disease, and Intermittent Oesophageal Dysphagia. These various conditions exhibit some or all of the symptoms listed above, they vary slightly but are all caused by the corrosive effect of the refluxed stomach acids. Reflux has an aggravating effect on those with esophagitis.

Another form of reflux is non-acid reflux, this can be diagnosed by impedance and 24-hour pH study. Even though the refluxed stomach contents are not acidic – perhaps due to PPI suppression medication – it is still an unwanted symptom. For this reason, the HH should still be treated even though non-acid reflux is not thought to aggravate esophagitis.

If untreated, the effect of these acids on the oesophagus can lead to inflammation and Barrett's oesophagus. These altered cells can be a sign that they have entered a pre-cancerous phase. It has been shown that even after PPI medication that relieves symptoms, the cancer risk is undiminished [15]. It may be useful to describe the similarities and differences between the various conditions listed.

#### **3.1 GERD**

GERD and GORD are the same thing and the name varies only because people spell (o) oesophagus with or without an 'O' in the beginning. It is an abbreviation for Gastroesophageal Reflux Disease.

This condition means that stomach acids bubble up from the stomach, into the oesophagus and up to the throat, larynx and pharynx. The effect of these acids is to cause persistent symptoms like heartburn, a feeling of something stuck in the throat, pain behind the breastbone, difficulties in swallowing some foods, persistent non-productive cough, thick phlegm or frothy saliva, and regurgitation.

#### **3.2 LPR**

LPR is an abbreviation for LaryngoPharyngeal Reflux. In this condition stomach acids sometimes bubble up as described earlier and cause the symptoms of heartburn, sore throat, irritation in the larynx and vocal cords, and hoarseness. When the symptoms do not include heartburn, it is often called Silent Reflux instead.

With LPR, unlike similar oesophageal conditions like GERD, the oesophagus itself is not usually irritated, nor does one usually suffer from the impression of something stuck in the throat or behind the breastbone.

#### **3.3 Silent reflux**

In this condition stomach acids sometimes bubble up as described earlier and cause the symptoms of sore throat, irritation in the larynx and vocal cords, and hoarseness.

With Silent Reflux, unlike similar oesophageal conditions like GERD, the oesophagus itself is not usually irritated, nor does one usually suffer from the impression of something stuck in the throat or behind the breastbone. Because the symptoms are less obvious than GERD, the condition is known as Silent Reflux. If heartburn is present in addition to the above symptoms the condition is more often described as LPR.

#### **3.4 Heartburn**

Heartburn is a condition that everybody experiences occasionally. It is normal after, for example, a heavy meal or fizzy drinks. Constant or persistent heartburn is *Introducing an Innovative Oral Neuromuscular Treatment of the Underlying Reason… DOI: http://dx.doi.org/10.5772/intechopen.96773*


#### **Figure 1.**

*Symptom comparisons in reflux diseases.*

usually diagnosed by doctors as being caused by reflux which sometimes has the related symptoms of sore throat, irritation in the larynx and vocal cords and hoarseness (**Figure 1**).
