The Efficacy of 4-week Short-term Therapy with Proton Pump Inhibitor as an Initial Treatment Regimen for the Patients with Laryngopharyngeal Reflux

Chung, Man Ki; Min, Jin Young; Oh, Jae Won; Jeong, Han Sin; Baek, Chung Hwan; Son, Young Ik

Abstract

BACKGROUND AND OBJECTIVES
Proton pump inhibitors (PPIs) can improve the symptoms of laryngopharyngeal reflux (LPR) if used for more than 8 weeks, but little information is available on the effects of short-term PPI therapy as an initial treatment for LPR. We aimed to evaluate the efficacy of 4-week short-term PPI medication as an initial treatment for LPR and to identify specific symptoms which can predict the outcome of treatment. SUBJECTS AND METHOD: Among the patients complaining of more than 3 typical LPR symptoms for over 3 months, 62 patients with LPR symptom scores over 8 points were enrolled for the study. The patients were randomly subjected either to the 4 weeks of prokinetics (n=31) or PPI (n=31) medication. Changes in subjective symptoms and objective findings were assessed at first visit and 4 weeks after the medication. RESULTS: Treatment with prokinetics or PPI resulted in more than 50% reduction of LPR symptom scores in 9.6% or 29% of the patients respectively and 25-50% reduction in 54.8% or 70.9% of them. Objective reflux findings didn't get improved in either group. Analyses of the obtained reflux symptom scores failed to predict the treatment outcome of PPI medication. CONCLUSION: Short-term PPI therapy is highly effective for the reduction of LPR symptoms in selected patients, which may validate the use of PPI as an initial treatment regimen for the patients with LPR. However, further studies are required to assess the long-term effects of 4-week PPI therapy as an initial treatment regimen.