Yes — I think the pepsin side of LPR is genuinely interesting, and there’s actually been quite a bit of research on it over the years. The basic idea is that pepsin (a digestive enzyme from the stomach) may continue irritating throat tissue even when acid itself isn’t very high, which could help explain why some people have LPR symptoms without much classic heartburn. ([ResearchGate][1])

Dr. Nikki Johnston is probably the main researcher you’re referring to. Her group has published a lot of work on pepsin and LPR, and there are even newer studies looking into drugs that directly target pepsin rather than just reducing stomach acid. ([PMC][2])

That said, I don’t think pepsin fully explains every case of LPR. The condition is probably multifactorial — acid, pepsin, bile reflux, motility issues, diet, nervous system sensitivity, inflammation, etc. all likely play a role depending on the person. ([PMC][3])

But overall, yes — I do think the pepsin theory has real merit and helps explain why some people improve with low-acid diets, alginates, and alkaline water even when PPIs alone don’t fully solve things.

Of course I’m happy to help. Best of luck and if you have any more questions just let me know.