J Korean Soc Laryngol Phoniatr Logoped.
2016 Dec;27(2):78-83. 10.0000/jkslpl.2016.27.2.78.
Dogma of Extraesophaghgeal Reflux
- Affiliations
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- 1Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hallym University, Hwaseong, Korea. ispark@hallym.or.kr
- KMID: 2369113
- DOI: http://doi.org/10.0000/jkslpl.2016.27.2.78
Abstract
- Laryngopharyngeal reflux (LPR) disease is an extraoesophageal variant of gastro-esophageal reflux disease that can affect the larynx and pharynx. LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.
