Normal esophageal physiology and laryngopharyngeal reflux.

Understanding the basic anatomy and physiology contributing to esophageal peristalsis can help with comprehension of esophageal disease states. Laryngopharyngeal reflux (LPR), an extraesophageal variant of gastroesophageal reflux disease, is retrograde movement of gastric contents into the laryngopharynx and is associated with hoarseness, chronic cough, throat clearing, sore throat, and dysphagia. Various direct and indirect mechanisms have been proposed to contribute to LPR. The current diagnostic tests for LPR have significant shortcomings. This article reviews the anatomy and physiology of upper esophageal sphincter, esophagus, and lower esophageal sphincter, and discusses current understanding of pathophysiology, evaluation, and management of LPR.