From personal struggle to professional passion—Dr. Inna Husain shares how silent reflux shaped her path as a leading LPR specialist. In this eye-opening conversation, she breaks down the complexities of diagnosis and treatment, offering empowering, evidence-based guidance to help others find lasting relief.
Introduction and Personal Journey
Josef Kreitmayer
Welcome to another amazing session here at the Reflux Summit. We are very happy to welcome Dr. Inna Husain. She’s an expert on LPR—laryngopharyngeal reflux, also called silent reflux—which we’ll be discussing today.
Dr. Husain is a board-certified otolaryngologist and head and neck surgeon specializing in laryngology, voice, airway, and swallowing disorders. She trained at Northwestern and Harvard, has published extensively, and now serves as medical director of laryngology at Powers Health in Munster, Indiana. Welcome!
Dr. Inna Husain
Thank you, Josef. That was a very thorough introduction.
What I would add is that I’m also a fellow reflux sufferer. Like many people attending this summit, I’ve done my own investigations to find answers, and I truly understand the struggle. I’m happy to be here to chat.
Josef Kreitmayer
How did you first become interested in ENT and especially LPR? Was it your personal experience?
Dr. Inna Husain
Yes, though it didn’t start with reflux. I’m actually a second-generation ENT—my mom is also in the field. I grew up surrounded by ENT conversations.
During medical school, I fell in love with the specialty myself. In my third year of training at Northwestern, I discovered laryngology through pediatric voice and swallowing cases. I was fascinated by the larynx and how connected it is to other systems.
I didn’t want to work with kids long-term, so I transitioned into adult laryngology. That’s when I began seeing reflux manifestations outside the esophagus—and realized I had many of those symptoms myself. That personal connection solidified my path into LPR.
Barriers to Diagnosis and Awareness
Josef Kreitmayer
It can be difficult to identify LPR. I also have it, and it took me a year to figure it out.
Dr. Inna Husain
Absolutely. I originally thought my symptoms were allergies, but allergy treatments didn’t help. Eventually, my symptoms worsened and I developed significant swallowing problems.
I even had two near-choking episodes. At that point, it became clear something more serious was happening.
Josef Kreitmayer
How does your personal experience affect the way you work with patients?
Dr. Inna Husain
I think it gives me a lot of empathy. I also recognize how confusing it is once someone receives an LPR diagnosis. Many patients ask, “Now what?”
Resources are limited, and people often feel lost after the diagnosis.
Josef Kreitmayer
You’ve become a key voice on social media about LPR. How did that start?
Dr. Inna Husain
It happened organically. I noticed how many of my laryngology patients had LPR. Some studies suggest up to 50 percent of ENT complaints may be related to silent reflux.
At the time, treatment was mostly acid suppression. I began sharing what I observed on Instagram, and people reached out saying they had the same symptoms. That response encouraged me to keep educating.
Diagnostic Challenges and Initial Management
Josef Kreitmayer
What’s the biggest challenge in diagnosing LPR?
Dr. Inna Husain
Most symptoms are in the throat—mucus, throat clearing, chronic cough, and globus sensation. That area is difficult to evaluate.
Diagnosis shouldn’t be based on symptoms alone because they’re nonspecific. A nasal laryngoscopy performed by an ENT is essential, but even among ENTs, understanding of LPR varies.
So patients may still feel uncertain even after being examined.
Josef Kreitmayer
Sometimes PPIs don’t help. What happens then?
Dr. Inna Husain
That’s very common. We usually start with diet and lifestyle changes—how and what you eat matter a lot.
I often recommend working with a nutritionist and using alginates, which are safer than long-term acid suppression.
If symptoms don’t improve, then we move on to further diagnostic testing.
Common Symptoms and Differential Diagnosis
Josef Kreitmayer
What symptoms do you see most often?
Dr. Inna Husain
Mucus and throat clearing are the most common, followed by chronic cough.
Many patients come to me after seeing pulmonologists or multiple ENTs. In severe cases, people experience pain, tightness, or difficulty swallowing.
When symptoms persist, a full diagnostic workup is crucial because many ENT conditions can mimic LPR—such as rhinitis, adenoid inflammation, or esophageal dysmotility.
LPR vs GERD and the Role of Hypersensitivity
Josef Kreitmayer
How is LPR different from GERD?
Dr. Inna Husain
They are distinct conditions. GERD affects the esophagus and typically causes heartburn. LPR affects the throat and doesn’t always cause tissue damage.
The larynx is extremely sensitive and can react to even gaseous reflux. LPR is often more complex, partly due to vagus nerve involvement and hypersensitivity.
Josef Kreitmayer
Can people feel pain even without visible damage?
Dr. Inna Husain
Yes. Similar to functional heartburn, people can experience significant symptoms due to peripheral or central vagus nerve hypersensitivity—even without structural injury.
Vagal Hypersensitivity and Hypervigilance
Josef Kreitmayer
Patients with hypersensitivity are often dismissed, but their pain is real.
Dr. Inna Husain
Exactly. I frame it as vagus nerve hypersensitivity rather than simply being “too sensitive.”
The vagus nerve is influenced by emotional and psychological states. We often see hypervigilance, where people become intensely focused on throat sensations, amplifying symptoms.
Risks, Pepsin, and Long-Term Impacts
Josef Kreitmayer
Are there long-term risks like throat cancer?
Dr. Inna Husain
Any persistent throat symptom needs evaluation. LPR symptoms are nonspecific, and while cancer is rare, it must be ruled out.
Pepsin is also concerning. It can lodge in throat tissue and be reactivated by acid, potentially contributing to inflammation. Long-term data is still limited.
Alginates and Lifestyle Adjustments
Josef Kreitmayer
Alginates help manage symptoms but don’t fix the root cause, correct?
Dr. Inna Husain
Correct. They form a barrier to reduce reflux events but don’t address underlying causes like diet, stress, or anatomy.
They’re more common in Europe but are slowly gaining awareness in the U.S.
Lifestyle Changes and Treatment Approaches
Josef Kreitmayer
What lifestyle changes matter most?
Dr. Inna Husain
It depends on symptoms. For throat pain or mucus, reducing dietary acidity is key.
For cough, portion control is critical. Overeating increases pressure and reflux.
Josef Kreitmayer
Why don’t PPIs work well for LPR?
Dr. Inna Husain
PPIs treat acid, but LPR often involves non-acid reflux and pepsin.
If someone has both GERD and LPR, PPIs may help GERD but won’t fully resolve LPR symptoms.
Comprehensive Treatment Plans
Josef Kreitmayer
Once diagnosed, what does treatment look like?
Dr. Inna Husain
We refine diet and lifestyle and assess for structural issues like hiatal hernia or H. pylori.
I may recommend voice therapy to reduce muscle tension, hydration strategies, and sometimes medical weight loss or newer medications.
Ideal Diagnostic Process and Prognosis
Josef Kreitmayer
What’s the ideal diagnostic process?
Dr. Inna Husain
Start with an ENT evaluation. Additional testing may include endoscopy, barium swallow, manometry, or pH impedance studies. Each test contributes to a full picture.
Josef Kreitmayer
Can LPR be cured?
Dr. Inna Husain
It depends on the cause. Some cases can go into remission with lifestyle changes. Others, such as those related to anatomy, may be chronic. Every case is unique.
Holistic View and Cross-Disciplinary Care
Josef Kreitmayer
Can gut issues like SIBO or food sensitivities contribute?
Dr. Inna Husain
Absolutely. The throat, esophagus, and sinuses share mucosal linings. Everything is connected.
Collaboration across specialties is essential.
Advocacy and Final Advice
Josef Kreitmayer
How can patients prepare for doctor visits?
Dr. Inna Husain
Be prepared. Ask for a throat exam, discuss differential diagnoses, and ask what tests are available. Advocate for yourself.
Josef Kreitmayer
Any final advice for those starting their LPR journey?
Dr. Inna Husain
Don’t lose hope. Even if you’ve seen many doctors, there may still be options.
You’ll likely need both an ENT and a GI specialist. Use research tools like PubMed and seek out experts.
Josef Kreitmayer
Thank you so much for this interview.
Dr. Inna Husain
Thank you for the opportunity. I’m passionate about helping people with LPR, and the future is promising as awareness and research continue to grow.
