Laryngopharyngeal reflux (LPR) is a condition where stomach contents travel up the esophagus to the throat and voice box. Unlike typical reflux, LPR often presents without heartburn, earning it the nickname “silent reflux”. Instead, individuals frequently experience symptoms such as persistent throat clearing, a sensation of a lump in the throat, and hoarseness.
LPR Explained
Laryngopharyngeal reflux occurs when stomach acid and digestive enzymes, like pepsin, flow backward from the stomach into the pharynx (throat) and larynx (voice box). Unlike the esophagus, these delicate tissues are not designed to withstand corrosive stomach contents, leading to irritation and inflammation in the upper airway.
LPR differs from gastroesophageal reflux disease (GERD) because it typically does not cause heartburn. While GERD involves acid backing up into the esophagus, LPR involves reflux reaching higher into the throat and voice box.
Symptoms of LPR often involve the head and neck region. Individuals may experience:
- Chronic cough
- Excessive mucus or phlegm
- Difficulty swallowing
- Sore throat
- Bitter taste in the mouth or vocal fatigue
The Lymphatic System and Swollen Nodes
The lymphatic system is part of the body’s immune system, defending against invaders. Lymph nodes are small, bean-shaped structures distributed throughout this system, filtering a clear fluid called lymph. Many nodes are found in the neck, armpits, and groin.
Lymph nodes contain specialized immune cells, such as lymphocytes, which identify and destroy harmful substances like bacteria, viruses, and abnormal cells. When the body encounters an infection or inflammation, these immune cells activate and multiply within the lymph nodes. This increased activity causes the lymph nodes to swell and sometimes become tender, signaling an active immune response.
This enlargement is a normal bodily reaction, indicating the immune system is working to clear infection or foreign matter. Swelling typically occurs in nodes near the site of the problem, such as neck nodes for a throat infection. This process helps the body contain and neutralize threats before they spread.
Investigating the Connection: LPR and Lymph Nodes
Swollen lymph nodes are not a primary symptom directly caused by laryngopharyngeal reflux. LPR involves irritation and inflammation of the throat and voice box lining due to stomach contents, not an infection of the lymph nodes. However, chronic irritation from LPR can contribute to localized inflammation in the throat area.
This persistent inflammation may activate nearby lymph nodes as part of the body’s general immune response. Lymph nodes in the neck might become slightly enlarged or reactive due to the ongoing irritation of surrounding tissues. This is an indirect effect, where nodes respond to the inflammatory process.
Any swelling would be a reactive response to the chronic irritation of the throat and larynx. Such reactive nodes are usually soft, movable, and may or may not be tender to the touch.
Other Reasons for Swollen Lymph Nodes
Swollen lymph nodes most often indicate the body is fighting an infection. Common causes in the neck area include upper respiratory infections like colds, flu, or strep throat. Ear, dental, and sinus infections can also lead to noticeable swelling in nearby nodes.
Viral infections such as mononucleosis or chickenpox can cause widespread or localized lymph node swelling. Less common but more serious conditions, including autoimmune diseases like lupus or rheumatoid arthritis, can also cause enlargement. Rarely, swollen lymph nodes may signal certain cancers, such as lymphoma or metastatic cancer.
Inflammatory conditions, skin infections, or reactions to certain medications or allergens can also trigger lymph node swelling. The location of the swollen nodes often provides clues about the underlying cause, as they tend to swell closest to the affected area.
When to Consult a Healthcare Professional
While swollen lymph nodes are often harmless and resolve on their own, medical evaluation is advisable in certain situations. Consult a healthcare professional if lymph nodes:
- Have no clear cause
- Continue to enlarge or remain swollen for more than two to four weeks
- Feel hard, fixed in place, or are growing rapidly
Seek medical advice if swollen lymph nodes are accompanied by other concerning symptoms, including:
- Unexplained weight loss
- Persistent fever
- Night sweats
- Difficulty breathing
A medical assessment is also recommended if the skin over the swollen node becomes red, inflamed, or if the node is draining pus.