Jerome R Lechien1,2,3,4, Sven Saussez1,2,4, Petros D Karkos1,5. 1. Laryngopharyngeal Reflux Study Group of Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. 2. Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology. 3. Laboratory of Phonetics, Faculty of Psychology, Research Institute for Language Sciences and Technology, University of Mons (UMONS), Mons. 4. Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium. 5. Department of Otorhinolaryngology and Head and Neck Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Abstract
PURPOSE OF REVIEW: To review the recent literature on presentation, diagnosis and treatment of laryngopharyngeal reflux. RECENT FINDINGS: Patients with laryngopharyngeal reflux have a higher risk for gastroesophageal reflux and respiratory-related diseases. Many symptoms and findings are underestimated, contributing to the inconclusive results of many therapeutic trials. Additionally, little significance is given to nonacid and mixed refluxates, although a significant prevalence. The association between symptoms, signs, impedance-pH studies and pepsin detection could be the most accurate way for a clear diagnosis. 'Reflux profiling' is also important for the administration of a personalized treatment based on diet, proton pump inhibitors, alginate, magaldrate and other second-line drugs. There are only a handful of studies focusing on the addition of alginate or magaldrate to the treatment of laryngopharyngeal reflux, although their contribution has extensively been demonstrated. SUMMARY: Diagnosis remains controversial despite improvement in impedance and availability of pepsin detection in daily practice. With recent studies exhibiting a significant prevalence of nonacid or mixed refluxes, the addition of alginate or magaldrate to proton pump inhibitors should be considered. Future studies are needed to assess these new therapeutic schemes in moderate and severe laryngopharyngeal reflux.
PURPOSE OF REVIEW: To review the recent literature on presentation, diagnosis and treatment of laryngopharyngeal reflux. RECENT FINDINGS:Patients with laryngopharyngeal reflux have a higher risk for gastroesophageal reflux and respiratory-related diseases. Many symptoms and findings are underestimated, contributing to the inconclusive results of many therapeutic trials. Additionally, little significance is given to nonacid and mixed refluxates, although a significant prevalence. The association between symptoms, signs, impedance-pH studies and pepsin detection could be the most accurate way for a clear diagnosis. 'Reflux profiling' is also important for the administration of a personalized treatment based on diet, proton pump inhibitors, alginate, magaldrate and other second-line drugs. There are only a handful of studies focusing on the addition of alginate or magaldrate to the treatment of laryngopharyngeal reflux, although their contribution has extensively been demonstrated. SUMMARY: Diagnosis remains controversial despite improvement in impedance and availability of pepsin detection in daily practice. With recent studies exhibiting a significant prevalence of nonacid or mixed refluxes, the addition of alginate or magaldrate to proton pump inhibitors should be considered. Future studies are needed to assess these new therapeutic schemes in moderate and severe laryngopharyngeal reflux.
Authors: Giannicola Iannella; Claudio Vicini; Antonella Polimeni; Antonio Greco; Riccardo Gobbi; Filippo Montevecchi; Andrea De Vito; Giuseppe Meccariello; Giovanni Cammaroto; Giovanni D'Agostino; Annalisa Pace; Raffaella Cascella; Marco Brunori; Cristina Anna Maria Lo Iacono; Stefano Pelucchi; Giuseppe Magliulo Journal: Int J Environ Res Public Health Date: 2019-06-10 Impact factor: 3.390
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