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Shortness of Breath

Laryngopharingeal reflux disease: from pathophysiology to treatment

Mini-Review, 61 - 72
doi: 10.11138/sob/2016.5.2.061
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Abstract
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Many patients experience ear, nose and throat symptoms associated with their gastroesophageal reflux disease. These symptoms are purportedly caused by reflux of gastroduodenal contents into the larynx, which leads to laryngopharyngeal reflux (LPR).
Various modalities are used to diagnose LPR, including ambulatory pH monitoring, laryngoscopy, and esophagogastroduodenoscopy, as well as a few new emerging diagnostic tests. However, there are no yet established diagnostic criteria or gold standard methods which can reliably distinguish LPR from other conditions. Numerous studies have investigated the role of proton pump inhibitor therapy in this patient population, but the results were disparate and often inconsistent. While only a subgroup of patients with LPR appears to respond to PPI therapy, most patients show no symptomatic improvement, particularly with regard to extraesophageal symptoms.
Thus, there is a vital need to explore alternative treatment options, including anti-reflux surgery, lifestyle changes, and other classes of medications to better address LPR management.
This review will evaluate currently available diagnostic tests and therapeutic options for patients with laryngeal signs and symptoms of chronic reflux disease.

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