A review of clinical practice guidelines for reflux disease: Toward creating a clinical protocol for the otolaryngologist

Altman, Kenneth W.; Prufer, Neil; Vaezi, Michael F.

doi:10.1002/lary.21429

Cited by 41 publications

(37 citation statements)

References 37 publications

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“…95 However, it is important to highlight that PPI therapy in LPR and twice daily dosing are both unapproved indications for these agents but one that is recommended by both GI and ENT experts and guidelines. 19,27,96 Treating suspected patients initially with twice daily therapy for no more than 2 months is a reasonable initial approach. If patients do not respond symptomatically with this approach it is likely that their symptoms are not reflux related unless they complain of regurgitation, which is a volume phenomenon that PPIs may not be able to control.…”

Section: Ppismentioning

confidence: 99%

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Therapeutic Strategies for Laryngeal Manifestations of Gastroesophageal Reflux Disease

Yüksel

Vaezi

2013

Journal of Clinical Gastroenterology

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Gastroesophageal reflux disease is increasingly associated with ear, nose, and throat symptoms, including laryngitis. Many patients are unaware of the gastroesophageal etiology of their symptoms. A variety of criteria are used to diagnose this condition, including laryngoscopy, esophagogastroduodenoscopy, and the use of ambulatory pH and impedance monitoring. However, no test serves as the gold standard for the diagnosis given their lack of sensitivity and specificity for reflux disease. Numerous trials have assessed the role of proton pump inhibitor therapy in patients with laryngopharyngeal reflux and most have revealed no benefit to acid suppression over placebo. Despite many uncertainties there has been some progress regarding the role of acid-suppressive therapy as well as other agents in this unique group of patients. In this review we explore therapeutic options and their rationale for patients with laryngeal signs and symptoms.

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Section: Ppismentioning

confidence: 99%

“…For an in-depth discussion of the diagnostic tests available for LPR, we refer the reader to recently published reviews. 1,[26][27][28] …”

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confidence: 99%

Therapeutic Strategies for Laryngeal Manifestations of Gastroesophageal Reflux Disease

Yüksel

Vaezi

2013

Journal of Clinical Gastroenterology

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“…Esophageal symptoms like regurgitation and heartburn that are seen in many GERD patients are considered typical, whereas extraesophageal symptoms such as globus sensation, hoarseness and cough are considered as atypical and are less common [2]. Atypical symptoms may occur due to reflux as well as other etiological factors such as smoking, allergies, sinusitis, inhaled medications, etc., and thus the etiology of atypical GERD symptoms is generally non-specific, with a wide spectrum of differential diagnoses.…”

Section: Introductionmentioning

confidence: 96%

The effect of antireflux surgery on laryngeal symptoms, findings and voice parameters

Şahin

Vardar

Ersin

et al. 2015

Eur Arch Otorhinolaryngol

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The aim of this study was to evaluate the effect of laparoscopic antireflux surgery (LARS) on the laryngeal symptoms, physical findings and voice parameters of gastroesophageal reflux disease (GERD) patients with or without laryngopharyngeal reflux (LPR). Forty-one GERD patients predominantly with LPR symptoms (Group I) and twenty-six GERD patients without LPR symptoms (Group II) who had LARS were prospectively analysed before and 2 years after the surgery. Upper gastrointestinal endoscopy, 24-h ambulatory pH or MII-pH monitoring was performed in all cases. A reflux study group including specialists from five departments in a university hospital decided surgical indications. Patients were asked to fill out a validated LPR and voice quality questionnaire (Reflux Symptom Index and Voice Handicap Index-10). Laryngeal findings were evaluated and scored using a laryngoscopic grading scale [Reflux Finding Score (RFS)], by four blinded ENT specialists. GRBAS scale was done by a blinded otolaryngologist. Voice parameters were measured objectively via the Multi Dimensional Voice Programme (MDVP). The mean age was 45.8 ± 8.5 for Group I (24 men) and 48.9 ± 12.3 for Group II (16 men). The mean follow-up after LARS was 24.5 ± 1.3 months for Group I and 25.2 ± 1.1 months for Group II. The preoperative mean score of RSI was 22.8 ± 7.4 vs. 11.2 ± 6.6; RFS was 10.6 ± 2.3 vs. 5.7 ± 2.5 and VHI was 18.07 ± 4.4 vs. 10.86 ± 3.3 for Group I and II, respectively. The postoperative mean score of RSI was 12.9 ± 6.4 vs. 8.4 ± 4.5; RFS was 6.9 ± 2.0 vs. 4.5 ± 2.3 and VHI was 9.59 ± 4.4 vs. 7.95 ± 3.5 for Group I and II, respectively. Group I had significantly lower RSI and RFS scores following LARS compared to the preoperative scores. LARS successfully improved RFS, RSI and VHI in carefully selected patients with GERD, especially the signs and symptoms related to the larynx and voice. Although the indications for LARS are limited in patients with LPR symptoms, these results favor the decision-making period of LARS.

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“…While most patients with gastroesophageal reflux disease (GERD) suffer from typical esophageal manifestations such as heartburn and regurgitation, there is a subset of patients who suffer from so-called laryngeal symptoms, which may be caused by laryngopharyngeal reflux (LPR) [1,2]. The clinical spectrum of LPR is vast and includes symptoms due to laryngeal irritation and inflammation such as cough, hoarseness, subglottic stenosis, globus sensation, and laryngeal cancer [3].…”

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confidence: 99%

Pepsin detection in patients with laryngopharyngeal reflux before and after fundoplication

et al. 2011

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A review of clinical practice guidelines for reflux disease: Toward creating a clinical protocol for the otolaryngologist

Cited by 41 publications

References 37 publications

Therapeutic Strategies for Laryngeal Manifestations of Gastroesophageal Reflux Disease

Therapeutic Strategies for Laryngeal Manifestations of Gastroesophageal Reflux Disease

The effect of antireflux surgery on laryngeal symptoms, findings and voice parameters

Pepsin detection in patients with laryngopharyngeal reflux before and after fundoplication

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