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Lifestyle and Dietary Modifications

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Laryngopharyngeal Reflux Disease

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Abstract

Laryngopharyngeal reflux (LPR) is commonly diagnosed by otolaryngologists and may be managed using various approaches. Traditionally, otolaryngologists treat LPR with a combination of medications and lifestyle modifications. These lifestyle changes are often the same as those provided for patients with gastroesophageal reflux disease (GERD), commonly referred to as acid reflux. While pharmacological therapy for LPR is well studied, there is a paucity of data on the effect of lifestyle modifications for treating LPR. Most studies are found in the gastroenterology literature and address esophageal rather than laryngopharyngeal symptoms. In this chapter, we will explore lifestyle and dietary modifications and their rationale for patients with laryngopharyngeal reflux and will discuss the evidence where available.

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References

  1. Asaoka D, Nagahara A, Matsumoto K, Hojo M, Watanabe S. Current perspectives on reflux laryngitis. Clin J Gastroenterol. 2014;7(6):471–5. https://doi.org/10.1007/s12328-014-0535-x.

    Article  PubMed  Google Scholar 

  2. Davids T, Sommer DD, Armstrong D. Survey of current perspectives on laryngopharyngeal reflux among Canadian otolaryngologists. J Otolaryngol Head Neck Surg. 2008;37(2):196–202. http://www.ncbi.nlm.nih.gov/pubmed/19128612. Accessed 13 Aug 2017.

    PubMed  Google Scholar 

  3. Altman KW, Prufer N, Vaezi MF. A review of clinical practice guidelines for reflux disease: toward creating a clinical protocol for the otolaryngologist, vol. 121: Wiley Subscription Services, Inc., A Wiley Company; 2011. p. 717–23. https://doi.org/10.1002/lary.21429.

    Article  Google Scholar 

  4. Steward DL, Wilson KM, Kelly DH, et al. Proton pump inhibitor therapy for chronic laryngo-pharyngitis: a randomized placebo-control trial. Otolaryngol Neck Surg. 2004;131(4):342–50. https://doi.org/10.1016/j.otohns.2004.03.037.

    Article  Google Scholar 

  5. Feinle C, Christen M, Grundy D, et al. Effects of duodenal fat, protein or mixed-nutrient infusions on epigastric sensations during sustained gastric distension in healthy humans. Neurogastroenterol Motil. 2002;14(2):205–13. http://www.ncbi.nlm.nih.gov/pubmed/11975721. Accessed 13 Aug 2017.

    Article  CAS  Google Scholar 

  6. El-Serag HB, Satia JA, Rabeneck L. Dietary intake and the risk of gastro-oesophageal reflux disease: a cross sectional study in volunteers. Gut. 2005;54(1):11–7. https://doi.org/10.1136/gut.2004.040337.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Fox M, Barr C, Nolan S, Lomer M, Anggiansah A, Wong T. The effects of dietary fat and calorie density on esophageal acid exposure and reflux symptoms. Clin Gastroenterol Hepatol. 2007;5(4):439–44. https://doi.org/10.1016/j.cgh.2006.12.013.

    Article  PubMed  Google Scholar 

  8. Hamdan A, Nassar J, Dowli A, Al Zaghal Z, Sabri A. Effect of fasting on laryngopharyngeal reflux disease in male subjects. Eur Arch Otorhinolaryngol. 2012;269(11):2361–6. https://doi.org/10.1007/s00405-012-2038-z.

    Article  PubMed  Google Scholar 

  9. Aviv JE. Killing me softly from inside: the mysteries & dangers of acid reflux and its connection to America’s fastest growing cancer, with a diet that may save your life. CreateSpace Scotts Valley, CA: Independent Publishing Platform; 2013.

    Google Scholar 

  10. Aviv JE. The acid watcher diet: a 28-day reflux prevention and healing program. 1st ed. New York: Harmony; 2017.

    Google Scholar 

  11. Koufman J, Stern J, Bauer M. Dropping acid: the reflux diet cookbook & cure. 1st ed. Elmwood Park: Reflux Cookbooks, L.L.C; 2010.

    Google Scholar 

  12. Koufman JA. Low-acid diet for recalcitrant laryngopharyngeal reflux: therapeutic benefits and their implications. Ann Otol Rhinol Laryngol. 2011;120(5):281–7. https://doi.org/10.1177/000348941112000501.

    Article  PubMed  Google Scholar 

  13. Nilsson M, Johnsen R, Ye W, Hveem K, Lagergren J. Lifestyle related risk factors in the aetiology of gastro-oesophageal reflux. Gut. 2004;53(12):1730–5. https://doi.org/10.1136/gut.2004.043265.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Kaltenbach T, Crockett S, Gerson LB. Are lifestyle measures effective in patients with gastroesophageal reflux disease? Arch Intern Med. 2006;166(9):965. https://doi.org/10.1001/archinte.166.9.965.

    Article  PubMed  Google Scholar 

  15. Newberry C, Lynch K. Can we use diet to effectively treat Esophageal disease? A review of the current literature. Curr Gastroenterol Rep. 2017;19(8):38. https://doi.org/10.1007/s11894-017-0578-5.

    Article  PubMed  Google Scholar 

  16. Duroux P, Bauerfeind P, Emde C, Koelz HR, Blum AL. Early dinner reduces nocturnal gastric acidity. Gut. 1989;30(8):1063–7. http://www.ncbi.nlm.nih.gov/pubmed/2767502. Accessed 6 Sept 2017.

    Article  CAS  Google Scholar 

  17. Piesman M, Hwang I, Maydonovitch C, Wong RKH. Nocturnal reflux episodes following the administration of a standardized meal. Does timing matter? Am J Gastroenterol. 2007;102(10):2128–34. https://doi.org/10.1111/j.1572-0241.2007.01348.x.

    Article  PubMed  Google Scholar 

  18. Aslam M, Slaughter JC, Goutte M, Garrett CG, Hagaman D, Vaezi MF. Nonlinear relationship between body mass index and esophageal acid exposure in the extraesophageal manifestations of reflux. Clin Gastroenterol Hepatol. 2012;10(8):874–8. https://doi.org/10.1016/j.cgh.2011.12.032.

    Article  PubMed  Google Scholar 

  19. Pandolfino JE, Kwiatek MA, Kahrilas PJ. The pathophysiologic basis for epidemiologic trends in gastroesophageal reflux disease. Gastroenterol Clin North Am. 2008;37(4):827–43. https://doi.org/10.1016/j.gtc.2008.09.009.

    Article  PubMed  Google Scholar 

  20. Kjellin A, Ramel S, Rössner S, Thor K. Gastroesophageal reflux in obese patients is not reduced by weight reduction. Scand J Gastroenterol. 1996;31(11):1047–51. http://www.ncbi.nlm.nih.gov/pubmed/8938895. Accessed 6 Sept 2017.

    Article  CAS  Google Scholar 

  21. Fraser-Moodie CA, Norton B, Gornall C, Magnago S, Weale AR, Holmes GK. Weight loss has an independent beneficial effect on symptoms of gastro-oesophageal reflux in patients who are overweight. Scand J Gastroenterol. 1999;34(4):337–40. http://www.ncbi.nlm.nih.gov/pubmed/10365891. Accessed 6 Sept 2017.

    Article  CAS  Google Scholar 

  22. Anderson JW, Jhaveri MA. Reductions in medications with substantial weight loss with behavioral intervention. Curr Clin Pharmacol. 2010;5(4):232–8. http://www.ncbi.nlm.nih.gov/pubmed/20925648. Accessed 6 Sept 2017.

    Article  Google Scholar 

  23. Pandolfino JE, Bianchi LK, Lee TJ, Hirano I, Kahrilas PJ. Esophagogastric junction morphology predicts susceptibility to exercise-induced reflux. Am J Gastroenterol. 2004;99(8):1430–6. https://doi.org/10.1111/j.1572-0241.2004.30515.x.

    Article  PubMed  Google Scholar 

  24. Nocon M, Labenz J, Willich SN. Lifestyle factors and symptoms of gastro-oesophageal reflux – a population-based study. Aliment Pharmacol Ther. 2006;23(1):169–74. https://doi.org/10.1111/j.1365-2036.2006.02727.x.

    Article  CAS  PubMed  Google Scholar 

  25. Dore MP, Maragkoudakis E, Fraley K, et al. Diet, lifestyle and gender in gastro-esophageal reflux disease. Dig Dis Sci. 2008;53(8):2027–32. https://doi.org/10.1007/s10620-007-0108-7.

    Article  PubMed  Google Scholar 

  26. Pehl C, Wendl B, Pfeiffer A, Schmidt T, Kaess H. Low-proof alcoholic beverages and gastroesophageal reflux. Dig Dis Sci. 1993;38(1):93–6. http://www.ncbi.nlm.nih.gov/pubmed/8420765. Accessed 4 Sept 2017.

    Article  CAS  Google Scholar 

  27. Pehl C, Wendl B, Pfeiffer A. White wine and beer induce gastro-oesophageal reflux in patients with reflux disease. Aliment Pharmacol Ther. 2006;23(11):1581–6. https://doi.org/10.1111/j.1365-2036.2006.02922.x.

    Article  CAS  PubMed  Google Scholar 

  28. Pehl C, Pfeiffer A, Wendl B, Kaess H. Different effects of white and red wine on lower esophageal sphincter pressure and gastroesophageal reflux. Scand J Gastroenterol. 1998;33(2):118–22. http://www.ncbi.nlm.nih.gov/pubmed/9517519. Accessed 4 Sept 2017.

    Article  CAS  Google Scholar 

  29. Orr WC, Robinson MG, Johnson LF. Acid clearance during sleep in the pathogenesis of reflux esophagitis. Dig Dis Sci. 1981;26(5):423–7. http://www.ncbi.nlm.nih.gov/pubmed/7249882. Accessed 4 Sept 2017.

    Article  CAS  Google Scholar 

  30. Khan BA, Sodhi JS, Zargar SA, et al. Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux. J Gastroenterol Hepatol. 2012;27(6):1078–82. https://doi.org/10.1111/j.1440-1746.2011.06968.x.

    Article  PubMed  Google Scholar 

  31. Scott DR, Simon RA. Supraesophageal reflux: correlation of position and occurrence of acid reflux–effect of head-of-bed elevation on supine reflux. J Allergy Clin Immunol Pract. 2015;3(3):356–61. https://doi.org/10.1016/j.jaip.2014.11.019.

    Article  PubMed  Google Scholar 

  32. Khoury RM, Camacho-Lobato L, Katz PO, Mohiuddin MA, Castell DO. Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease. Am J Gastroenterol. 1999;94(8):2069–73. https://doi.org/10.1111/j.1572-0241.1999.01279.x.

    Article  CAS  PubMed  Google Scholar 

  33. Herwaarden MA, Katzka DA, Smout AJPM, Samsom M, Gideon M, Castell DO. Effect of different recumbent positions on postprandial gastroesophageal reflux in normal subjects. Am J Gastroenterol. 2000;95(10):2731–6. https://doi.org/10.1111/j.1572-0241.2000.03180.x.

    Article  PubMed  Google Scholar 

  34. MedCline Acid Reflux/GERD Pillow System. https://www.medcline.com/. Accessed 8 Oct 2017.

  35. Tierney WS, Gabbard SL, Milstein CF, Benninger MS, Bryson PC. Treatment of laryngopharyngeal reflux using a sleep positioning device: a prospective cohort study. Am J Otolaryngol. 2017;38(5):603–7. https://doi.org/10.1016/j.amjoto.2017.06.012.

    Article  PubMed  Google Scholar 

  36. Lechien JR, Finck C, Huet K, et al. Impact of age on laryngopharyngeal reflux disease presentation: a multi-center prospective study. Eur Arch Otorhinolaryngol. 2017. https://doi.org/10.1007/s00405-017-4671-z.

    Article  Google Scholar 

  37. Lee YC, Lee JS, Kim SW, Kwon KH, Eun YG. Influence of age on treatment with proton pump inhibitors in patients with laryngopharyngeal reflux disease. JAMA Otolaryngol Neck Surg. 2013;139(12):1291. https://doi.org/10.1001/jamaoto.2013.5556.

    Article  Google Scholar 

  38. Relieve heartburn symptoms by drinking alkaline water – RefluxMD. http://www.refluxmd.com/relieve-heartburn-symptoms-alkaline-water/. Accessed 13 Aug 2017.

  39. Ayazi S, Hagen JA, Zehetner J, et al. Loss of alkalization in proximal esophagus: a new diagnostic paradigm for patients with laryngopharyngeal reflux. J Gastrointest Surg. 2010;14(11):1653–9. https://doi.org/10.1007/s11605-010-1327-3.

    Article  PubMed  Google Scholar 

  40. Johnston N, Dettmar PW, Bishwokarma B, Lively MO, Koufman JA. Activity/stability of human pepsin: implications for reflux attributed laryngeal disease. Laryngoscope. 2007;117(6):1036–9. https://doi.org/10.1097/MLG.0b013e31804154c3.

    Article  PubMed  Google Scholar 

  41. Zalvan CH, Hu S, Greenberg B, Geliebter J. A comparison of alkaline water and mediterranean diet vs proton pump inhibition for treatment of laryngopharyngeal reflux. JAMA Otolaryngol Head Neck Surg. 2017;143(10):1023–9. https://doi.org/10.1001/jamaoto.2017.1454.

    Article  PubMed  PubMed Central  Google Scholar 

  42. The first wearable acid reflux control device | Reza Band. https://www.rezaband.com/?utm_expid=93170412-3.XrXjA4w9R7Kc4iW1YQj4pQ.0&utm_referrer=https%3A%2F%2Fwww.rezaband.com%2Flpracid-refluxgerd. Accessed 6 Sept 2017.

  43. Shaker R, Babaei A, Naini SR. Prevention of esophagopharyngeal reflux by augmenting the upper esophageal sphincter pressure barrier. Laryngoscope. 2014;124(10):2268–74. https://doi.org/10.1002/lary.24735.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Silvers SL. Nonrandomized prospective study of an upper esophageal sphincter (UES) assist device for treating laryngopharyngeal reflux. Otolaryngol Head Neck Surg. 2014;151(1_suppl):P44–4. https://doi.org/10.1177/0194599814541627a50.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA

    Suraj Kedarisetty & Ahmed M. S. Soliman

Authors
  1. Suraj Kedarisetty
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  2. Ahmed M. S. Soliman
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Correspondence to Ahmed M. S. Soliman .

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Editors and Affiliations

  1. Division of Otolaryngology-Head & Neck Surgery, University of Texas Rio Grande Valley School of Medicine, Edinburg, TX, USA

    Nausheen Jamal

  2. Department of Head and Neck Surgery, UCLA David Geffen School of Medicine, Los Angeles, CA, USA

    Marilene B. Wang

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Kedarisetty, S., Soliman, A.M.S. (2019). Lifestyle and Dietary Modifications. In: Jamal, N., Wang, M. (eds) Laryngopharyngeal Reflux Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-12318-5_4

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  • DOI: https://doi.org/10.1007/978-3-030-12318-5_4

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-030-12318-5

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