A Comparison of Alkaline Water and Mediterranean Diet vs Proton Pump Inhibition for Treatment of Laryngopharyngeal Reflux

Abstract

Our data suggest that the effect of PPI on the RSI based on proportion reaching a 6-point reduction in RSI is not significantly better than that of alkaline water, a plant-based, Mediterranean-style diet, and standard reflux precautions, although the difference in the 2 treatments could be clinically meaningful in favor of the dietary approach. The percent reduction in RSI was significantly greater with the dietary approach. Because the relationship between percent change and response to treatment has not been studied, the clinical significance of this difference requires further study. Nevertheless, this study suggests that a plant-based diet and alkaline water should be considered in the treatment of LPR. This approach may effectively improve symptoms and could avoid the costs and adverse effects of pharmacological intervention as well as afford the additional health benefits associated with a healthy, plant-based diet.

Trigger Reduction Prior to Systemic Drugs for Neurogenic Chronic Cough

“…Theoretically, this approach could decrease stimulation of the various chemo‐ and mechanoreceptors and thus diminish the peripheral stimulation. To theoretically address potential upregulated acid and chemoreceptors, we used an approach of treating LPR using a diet‐based approach that we previously demonstrated to be as efficacious if not more so in controlling laryngopharyngeal symptoms avoiding the use of proton pump inhibitor with their suggested potential side effects and costs . In addition, this diet‐based approach affords the improved health benefits of decreased heart disease, diabetes, stroke, and many cancers, highlighting the need for physician education to improve overall improvement in chronic disease outcomes.…”

“…A six‐point or greater reduction in the RSI score is considered a clinical responder . We have previously reported that standard reflux precautions, a Mediterranean diet, and alkaline water had resulted in a clinically significant six‐point reduction in the RSI score in 63% of patients . Using this criterion, patients were grouped as responders or nonresponders, and statistical significance was determined using the Fisher exact test with a placebo effect of 25%.…”

“…Rather than using systemic medication, trigger reduction can successfully treat many of these patients without the cost and potential adverse side effects. Our standard treatment with a trigger‐reduction approach using nasal toilet (nasal wash using saline irrigation, nasal steroid, and topical nasal antihistamine) combined with a dietary regimen for LPR was reviewed.…”

The factors associated with allergic rhinitis in the dysphonic professional voice users

“…LPR may even lead to carcinoma of the larynx. The LPR is considered to be mainly mediated through a process of exposure of the laryngopharynx to an acid environment in the presence of pepsin (7). The definition of LPR is extraoesophageal variant of gastroesophageal reflux disease, that affects the larynx and pharynx (8).…”

Alkaline, protein, low‐fat and low‐acid diet in laryngopharyngeal reflux disease: Our experience on 65 patients

“…1 To date, a very few number of studies interested to the impact of diet and lifestyle modifications on the improvement of symptoms, signs and voice quality in LPR disease. [5][6][7] However, with regard to the significant risk of adverse effects and the increasing cost of long-term PPI prescription, 5,6,8 diet and lifestyle modifications remain an interesting way for short and long-term control of LPR, especially in patients with chronic course.…”