PPI in Laryngopharyngeal Reflex as an Emerging Treatment Modality

Background: Laryngopharyngeal reflux is a highly prevalent disease and commonly encountered in the otolaryngologists office. Laryngopharyngeal reflux is different from classical gastroesophageal reflux disease in many ways. Laryngopharyngeal reflux refers to backflow of stomach contents into the throat that is into the hypopharynx. Proton pump inhibitors have become the treatment of choice even though conflicting results exists in their response. Treatment requires acid suppression to be as complete as possible and treatment failure is not uncommon Material and methods: About 70 patients diagnosed as a case of LPR on the basis of reflux finding score and and reflux symptom index were included in the study. we tried to evaluate the role of PPi in LPR management by observing the effect of PPi on reflux finding score and reflux symptom index. RESULTS: Foreign body sensation was the most common symptom present in 74 of patients followed by frequent clearing of throat in 64 and cough in 56 of patients. Mean RSI of all patients was 24.75 before treatment with proton pump inhibitors. After 8 weeks of therapy with PPi mean RSI dropped to 13.25 and after 16 weeks of PPi therapy mean RSI dropped to 13.25. Significant change in RSI occurred after first 8 weeks of therapy in total and in all age groups Conclusion: RFS of more than 7 and RSI of more than 13 are assoc iated with high risk of LPR. Even though we did not find any patient who did not respond, but vas reported in literature treatment failures are not uncommon. Still we need to perform more well designed, prospective large scale, probably mullticentric studies to find the role of PPi in LPR as many studies dont favour PPi over placebo.