Reflux that Occurs... Past the Throat... and Up Into the Nose!!!

Everyone has heard of reflux which medically is known as gastroesophageal reflux  (GERD). Some may even have heard of laryngopharyngeal reflux (LPR) which is reflux that extends past the chest and up into the throat.

However, few have heard of reflux that is even worse than LPR called nasopharyngeal reflux (NPR)where the reflux does not just reach the throat level, but extends past the throat and goes all the way up into the nose! Called nasopharyngeal reflux, this possibility is raised with certain abnormal endoscopic findings seen in the very back of the nose. Known as mulberry like changes of the posterior inferior nasal turbinate, the mucosa is not just swollen, but also bumpy in appearance as shown in the images above [reference]. The full clinical picture needs to be considered as well given mulberry inferior turbinates may also occur due to allergies and rhinitis medicamentosa, though the mucosa tends to be more "smooth" in appearance for these other conditions.

Treatment is still the same regardless whether GERD, LPR, or NPR.