LAUSR

Despite the large number of articles published on laryngopharyngeal reflux (LPR), an overview of the condition reveals many unclear points. Currently there is no ‘‘gold standard’’ for a definitive diagnosis of this very prevalent problem and its consequences. The concept of reflux appears to be present without objective criteria. On the other hand, epidemiological studies on this topic have shown an increase in its incidence.1,2 Is it more common in the community and overlooked by patients or physicians? Were patients whom we thought had LPR, in fact, misdiagnosed? Is this one of the reasons, or the main reason, for treatment failure in LPR? While the answers to these questions remain unclear, assessing the relevance of LPR and gastroesophageal reflux disease (GERD) based on what we know will contribute to a better understanding of the LPR concept and its unclear boundaries. The term gastroesophageal reflux refers to the backflow of gastric contents into the esophagus. Actually, it is a physiological condition. When this condition causes troublesome symptoms and/or signs affecting the quality of life of the patient, we called it pathological reflux. Two main ‘‘pathological’’ conditions are recognized: GERD and LPR. The term GERD is a clinical directional term that refers to excessive backflow rising (from the stomach to the esophagus) that causes esophageal tissue damage (esophagitis) and/or clinical symptoms (heartburn, regurgitation), also called typical reflux disease or heartburn reflux. The other main pathological condition, LPR, is a locational term meaning that refluxed material causes symptoms and/or signs into the laryngopharynx by different mechanisms. Numerous synonyms for LPR have been defined. The first known term was reflux-related laryngeal disease (reflux