Publication:

Laryngopharyngeal reflux- diagnosis and management at a tertiary care centre

Background Laryngopharyngeal reflux (LPR) disease is a clinical entity due to the retrograde flow of gastric contents into the pharynx. It can be considered as an extraesophageal syndrome of gastroesophageal reflux disease (GERD). The objective of the present study is to study the clinical profile of LPR and their response to treatment.

Methods 100 consecutive patients attending the outpatient department of ENT, presenting with a clinical profile of LPR were selected in the present study. The patients’ symptoms were evaluated based on the reflux symptom index (RSI) and was followed by an endoscopic examination of larynx and a scoring was made based on reflux finding score (RFS). An RSI score of ≥13 and RFS of >7 were considered for starting patients on LPR treatment. The patients were then put on treatment and followed up for 3 months.

Results In our study population the most common symptom was foreign body sensation in throat (52%). The most common sign noted on endoscopic examination of larynx was hyperemia/erythema of laryngeal tissue particularly bilateral arytenoids. Majority of our patients responded well to combination of pantoprazole (40 mg) and domperidon (30 mg) for 4 weeks. This was evaluated in terms of reduction in the RSI and RFS scores.

Conclusions LPR is more commonly encountered clinical entity and the otorhinolaryngologist should bear it in mind while treating patients for chronic complaints of throat pain, change in voice etc. Appropriate diagnosis and management of LPR can prevent unwarranted use of antibiotics and surgeries in these patients.