Esophageal Reflux vs LPR/Respiratory Reflux
When we think about the two forms of Reflux disease, Esophageal Reflux versus respiratory or LPR symptoms of reflux, the reason why the symptoms are different is because these diseases are caused by two different problems. In Esophageal Reflux, we are dealing more with stomach contents, whether that be basic contents like bile or acidic contents like acid, or digestive enzymes coming up and reacting within the esophagus to cause symptoms.
What’s really unique about the respiratory or LPR type of reflux which makes it so different from Esophageal Reflux is that it’s mostly aerosolized or more like a gaseous spray form of gastric contents that is predominantly going to be dominated by pepsin, which is absorbed into the tissues in the upper airways or larynx and then is reactivated not by acid coming from the stomach, but rather acid that we ingest as part of our diet. This is what accounts for the differences in the symptoms.