Reflux is a malfunction of the esophagus-stomach-system and indicates that fluids are going in a reverse direction from the stomach back into the esophagus – and may go all the way up to the larynx (laryngopharyngeal reflux – LPR). Stomach fluids are mostly acidic, contain pepsin, attack the mucosa and thus may be felt in the upper airway causing a great variety of symptoms like soreness of thraot, and may induce throat clearing, coughing and hoarseness.

In severe cases, LPR can cause a sudden closure reflex of the larynx with a spasm-like,acute choking feeling that induces momentarily a panic reaction when for many seconds breathing is totally blocked (previously this was called a VCD attack).

Comprehensive assessment of the pharynx, larynx, esophagus and trachea can be offered in an ambulatory examination with an absolutely pain-free transnasal flexible endoscopy in the unsedated patient. The video-based procedures are called transnasal laryngoscopy (TNL), transnasal esophagoscopy (TNE), transnasal tracheoscopy (TNT). Therapy may be multimodal and helps to get rid of reflux and related symptoms.