How to Understand and Treat Laryngopharyngeal Reflux.

Grace Snow, Shumon I Dhar, Lee M Akst

Journal: Gastroenterology clinics of North America 2022;50(4):871-884

PMID: 34717876

Full Text on Elsevier Science View on PubMed

Abstract

Laryngopharyngeal reflux (LPR) is frustrating, as symptoms are nonspecific and diagnosis is often unclear. Two main approaches to diagnosis are empiric treatment trials and objective reflux testing. Initial empiric trial of Proton pump inhibitors (PPI) twice daily for 2-3 months is convenient, but risks overtreatment and delayed diagnosis if patient complaints are not from LPR. Dietary modifications, H2-antagonists, alginates, and fundoplication are other possible LPR treatments. If objective diagnosis is desired or patients' symptoms are refractory to empiric treatment, pH testing with/without impedance should be considered. Additionally, evaluation for non-reflux etiologies of complaints should be performed, including laryngoscopy or videostroboscopy.

Address: Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, 6th Floor, Baltimore, MD 21287, USA.; Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins University School of Medicine, 601 North Caroline Street, 6th Floor, Baltimore, MD 21287, USA. Electronic address: [email protected].

DOI: 10.1016/j.gtc.2021.08.002

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MeSH Terms: Esophageal pH Monitoring, Fundoplication, Humans, Laryngopharyngeal Reflux, Overtreatment, Proton Pump Inhibitors