Therapeutic trial of proton pump inhibitors for management of patients with laryngopharyngeal reflux
Lenka Nosáková1, Martin Ďuriček Orcid.org 2, Peter Bánovčin Jr2, Denisa Gburová1, Peter Lipták2, Rudolf Hyrdel Orcid.org 2
1 Interná klinika gastroenterologická JLF UK a UN Martin
2 Interná klinika gastroenterologická JLF UK a UN Martin, Slovenská republika
Laryngopharyngeal reflux (LPR) is according to the current conception responsible for extraesophageal symptoms of gastroesophageal reflux disease. It is manifested by non-specific problems like cough, excess throat mucus, globus and others. The diagnosing is complicated as currently there is no diagnostic test which could definitely establish the association of LPR and emerged troubles. The therapeutic trial with proton pump inhibitors (PPIs) is a common clinical practice. In this study we have evaluated its efficiency in patients classified on the basis of symptoms. At the first visit patients filled in a reflux symptom index (RSI) questionnaire. In case of RSI positivity (RSI > 13) the PPI therapy twice daily was used during the next 3 months. Then we invited the patients for a check-up during which they filled in the RSI questionnaire again. We have found significant moderation of symptoms after the 3 months’ PPI treatment and the normalization of RSI (RSI ≤ 13) was achieved by 50% of patients. When assessing the treatment efficiency on the individual questions in the questionnaire we have ascertained the significant influence on the cough reduction after eating and in a lying position, troublesome cough, breathing difficulties and choking episodes. Therapeutic trial seems to be an effective way of initial management of patients with anticipated LPR which can be used after the cause of the problems is ruled out by other specialists.
Keywordsproton pump inhibitors, laryngopharyngeal reflux, reflux symptom index, gastroesophageal reflux disease
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