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Evaluation of Patients with Suspected Laryngopharyngeal Reflux: A Practical Approach

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Abstract

Laryngopharyngeal reflux (LPR) is associated with symptoms of laryngeal irritation such as throat pain, cough, and voice change. Currently, the two main diagnostic tools are laryngoscopy and reflux monitoring. On laryngoscopy, the signs most commonly used to diagnose LPR are erythema and edema of the larynx; however, these signs are not specific for LPR, may be associated with other causes, and may even be found in healthy individuals. In addition, pH testing has low sensitivity in diagnosing gastroesophageal reflux disease-related laryngeal findings. Proton pump inhibitor (PPI) therapy remains the cornerstone of treatment. The current management recommendation for this group of patients is empiric therapy with twice-daily PPIs for 1 to 2 months. In the majority of those who are unresponsive to such therapy, other causes of laryngeal irritation are considered. Surgical fundoplication is most effective in those who are responsive to acid-suppressive therapy.

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Disclosure

Conflicts of interest: A. Abou-Ismail—none; M.F. Vaezi—none.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Center for Swallowing and Esophageal Disorders, Digestive Disease Center, Vanderbilt University Medical Center, 1660 TVC, Nashville, TN, 37232-5280, USA

    Anas Abou-Ismail & Michael F. Vaezi

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  1. Anas Abou-Ismail
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  2. Michael F. Vaezi
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Correspondence to Michael F. Vaezi.

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Abou-Ismail, A., Vaezi, M.F. Evaluation of Patients with Suspected Laryngopharyngeal Reflux: A Practical Approach. Curr Gastroenterol Rep 13, 213–218 (2011). https://doi.org/10.1007/s11894-011-0184-x

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