Management of laryngopharyngeal reflux with proton pump inhibitors.

Therapeutics and Clinical Risk Management
Christina Reimer, Peter Bytzer

Abstract

There is a lack of consistent guidelines and consensus for the diagnosis of laryngopharyngeal reflux (LPR). A therapeutic trial with a proton pump inhibitor (PPI) has been suggested to identify patients with LPR. This review focuses on the current difficulties in diagnosing the disease and examines the evidence for the effectiveness of PPI therapy in suspected reflux-related laryngeal symptoms. Additionally, mode of action, safety, and tolerability of PPIs are described. A total of 7 placebo-controlled trials were identified and included in the review. All studies evaluated the effect of a PPI on symptoms and objective laryngoscopic findings in suspected LPR. Data from these trials show that PPI therapy is no more effective than placebo in producing symptom relief in patients suspected of LPR. Symptoms, laryngoscopic findings, or abnormal findings on pH monitoring will not predict response to PPI therapy. High placebo response levels suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Further studies are needed to characterize subgroups of patients with reflux-associated laryngeal symptoms that might benefit from treatment with PPI. Future studies should use validated patient reported ...Continue Reading

Citations

Mar 22, 2014·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Jonathan WaxmanMichael Friedman
Oct 1, 2014·The Laryngoscope·Michael DrinnanJanet A Wilson
Jul 27, 2018·Frontline Gastroenterology·Philip R HarveyNigel J Trudgill
May 31, 2014·Scandinavian Journal of Gastroenterology·Anders LødrupPeter Bytzer
Mar 13, 2019·The Laryngoscope·Friederike S Luetzenberg, Nancy Jiang
Sep 24, 2010·The Annals of Otology, Rhinology, and Laryngology·Nikki JohnstonJoel H Blumin
Jan 26, 2021·Health Technology Assessment : HTA·Janet A WilsonJames O'Hara

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