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European Archives of Oto-Rhino-Laryngology

, Volume 266, Issue 2, pp 243–251 | Cite as

The value of a liquid alginate suspension (Gaviscon Advance) in the management of laryngopharyngeal reflux

  • Julian A. McGlashan
  • Lesley M. Johnstone
  • John Sykes
  • Vicki Strugala
  • Peter W. Dettmar
Laryngology

Abstract

Laryngopharyngeal reflux (LPR) refers to the backflow of stomach contents into the laryngopharynx. Increasing evidence has demonstrated that LPR is a contributing factor in some cases of hoarseness, vocal fatigue, voice breaks, cough and globus and chronic throat clearing. However, several randomised placebo-controlled trials of proton pump inhibitors in the treatment of LPR have been reported with the majority showing no significant benefit in patient symptom scores over placebo. The aim of this pilot clinical study was to investigate whether any improvement in LPR-related symptoms, using the Reflux Symptom Index (RSI), and clinical findings, using the Reflux Finding Score (RFS), could be achieved with treatment with a liquid alginate suspension compared to control (no treatment). Patients presenting with the symptoms of LPR to the Otorhinolaryngology Outpatient Department at the Queen’s Medical Centre, Nottingham, UK were considered eligible if they had an RSI of greater than 10 and an RFS greater than 5 based on a fibreoptic examination of the larynx. A total of 49 patients were randomised into the open, parallel group study; 24 patients were randomised to receive 10 ml liquid alginate suspension (Gaviscon® Advance) four times daily after meals and at bedtime, and 25 patients into the control group (no treatment). Patients were assessed pre-treatment and at 2, 4 and 6 months post treatment. Mean (SD) RSI and RFS pre-treatment scores were 23.9 (7.0) and 10.4 (3.6) for the treatment group and 24.6 (7.4) and 10.3 (3.3) for the control group, respectively. Significant differences between treatment and control were observed for RSI at the 2-month (11.2 (7.0) vs. 16.8 (6.4), P = 0.005) and 6-month (11.2 (8.1) vs. 18.3 (9.4), P = 0.008) assessments and for RFS at the 6-month (7.1 (2.8) vs. 9.5 (3.4), P = 0.005) assessment. Significant improvement in symptom scores and clinical findings were achieved with liquid alginate suspension (Gaviscon® Advance) compared to control and further evaluation for the management of patients presenting with LPR is warranted.

Keywords

Laryngopharyngeal reflux Alginates Gastro-oesophageal reflux Larynx 

Abbreviations

ANCOVA

Analysis of covariance

FDA

Food and Drug Administration

GCP

Good clinical practice

GORD

Gastro-oesophageal reflux disease

GOR

Gastro-oesophageal reflux

ICH

International conference on harmonisation

ITT

Intention to treat

LOCF

Last observation carried forward

LPR

Laryngopharyngeal reflux

PPI

Proton pump inhibitor

RFS

Reflux Finding Score

RSI

Reflux Symptom Index

SD

Standard deviation

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Julian A. McGlashan
    • 1
  • Lesley M. Johnstone
    • 2
  • John Sykes
    • 2
  • Vicki Strugala
    • 3
  • Peter W. Dettmar
    • 3
  1. 1.Department of Otorhinolaryngology Head and Neck Surgery, Queen’s Medical CentreNottingham University HospitalNottinghamUK
  2. 2.Reckitt Benckiser Healthcare (UK) Ltd.HullUK
  3. 3.Technostics Limited, The Deep Business CentreHullUK

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