Meta-analysis of the efficacy of proton pump inhibitors for the symptoms of laryngopharyngeal reflux

Liu, C; Wang, H; Liu, K

doi:10.1590/1414-431x20165149

Cited by 35 publications

(30 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 21 A recent meta-analysis that included eight randomized and placebo controlled clinical trials has suggested no overall improvement of LPR with PPI therapy compared with placebo. 22 In our study, GERD patients with LPR symptoms have lower proportion of erosive esophagitis than those without LPR symptoms. It may support the notion that poorer response to acid suppression in GERD patients with LPR, 9 because efficacy in PPI therapy on symptom resolution is higher in patients with erosive esophagitis than those with non-erosive reflux disease.…”

Section: Discussionsupporting

confidence: 47%

See 1 more Smart Citation

Clinical and psychological characteristics in gastroesophageal reflux disease patients overlapping with laryngopharyngeal reflux symptoms

Wong

Bair

Chang

et al. 2019

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and Aim Laryngopharyngeal reflux (LPR) defined as reflux of gastric content reaching above the upper esophageal sphincter is frequently found in patients with gastroesophageal reflux disease (GERD). This study aimed to investigate clinical and psychological differences between GERD patients with or without LPR symptoms. Methods This study enrolled 303 consecutive patients with proton pump inhibitor treatment‐naïve scheduled for upper endoscopy because of troublesome reflux symptoms and recognized as GERD by non‐dyspepsia reflux disease questionnaire score. Included GERD patients were further categorized into two study groups: with or without LPR by reflux symptoms index score. All participants were also evaluated with questionnaires for depression, anxiety, and sleep disturbances. Results There were 132 (43.6%) GERD patients with LPR symptoms and 171 (56.4%) GERD patients without LPR symptoms. GERD patients with LPR symptoms had more depression (P < 0.001), sleep disturbance (P = 0.002), irritable bowel syndrome (P = 0.008), functional dyspepsia (P = 0.005), and reflux symptoms burden (P < 0.001) than those without LPR symptoms. Erosive esophagitis was more in patients without LPR symptoms (P = 0.03). GERD patients with LPR symptoms (28.8%) had more complex psychological distress than those without LPR symptoms (28.8% vs 14%, P < 0.001). Reflux symptoms burden, sleep disturbance, and erosive esophagitis were independently associated with GERD overlapping with LPR symptoms. Conclusions Gastroesophageal reflux disease patients with LPR symptoms appear to have more reflux symptoms, psychological distress, and functional gastrointestinal disturbance but less erosive esophagitis. This work suggests that therapeutic strategy with tailored multidimensional approach is promising for GERD patients overlapping with LPR symptoms.

show abstract

Section: Discussionsupporting

confidence: 47%

“…There was no evidence of a therapeutic benefit with PPI therapy for 16 weeks compared with placebo . A recent meta‐analysis that included eight randomized and placebo controlled clinical trials has suggested no overall improvement of LPR with PPI therapy compared with placebo …”

Section: Discussionmentioning

confidence: 99%

Clinical and psychological characteristics in gastroesophageal reflux disease patients overlapping with laryngopharyngeal reflux symptoms

Wong

Bair

Chang

et al. 2019

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…21 Three subsequent meta-analyses of controlled studies in LPR have suggested no benefit to PPI therapy overall; however, there was evidence that a subgroup of patients may benefit from such therapy. 9,88,89 Similar to patients with asthma and LPR, those with chronic cough are often treated with PPI therapy based on earlier studies suggesting that GERD is the third most common cause of chronic cough. 90,91 The recommendation of empiric therapy for reflux-related cough is solely based on open-label trials because placebo-controlled studies do not support a benefit to PPI therapy in this group.…”

Section: Medical Therapymentioning

confidence: 99%

Extraesophageal Symptoms and Diseases Attributed to GERD: Where is the Pendulum Swinging Now?

Vaezi

Katzka

Zerbib

2018

Clinical Gastroenterology and Hepatology

View full text Add to dashboard Cite

The purpose of this review is to outline the recent developments in the field of extraesophageal reflux disease and provide clinically relevant recommendations. The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed and EMbase. The Clinical Practice Updates Committee of the American Gastroenterological Association proposes the following recommendations: Best Practice Advice 1: The role of a gastroenterologist in patients referred for evaluation of suspected extra esophageal symptom is to assess for gastroesophageal etiologies that could contribute to the presenting symptoms. Best Practice Advice 2: Non-GI evaluations by ENT, pulmonary and/or allergy are essential and often should be performed initially in most patients as the cause of the extraesophageal symptom is commonly multifactorial or not esophageal in origin. Best Practice Advice 3: Empiric therapy with aggressive acid suppression for 6-8 weeks with special focus on response of the extraesophageal symptoms can help in assessing association between reflux and extraesophageal symptoms. Best Practice Advice 4: No single testing methodology exists to definitively identify reflux as the etiology for the suspected extra esophageal symptoms. Best Practice Advice 5: Constellation of patient presentation, diagnostic test results and response to therapy should be employed in the determination of reflux as a possible etiology in extra esophageal symptoms. Best Practice Advice 6: Testing may need to be off or on proton pump inhibitor (PPI) therapy depending on patients' presenting demographics and symptoms in assessing the likelihood of abnormal gastroesophageal reflux. A. On therapy testing may be considered in those with high probability of baseline reflux (those with previous esophagitis, Barrett's esophagus or abnormal pH). B. Off therapy testing may be considered in those with low probability of baseline reflux with the goal of identifying moderate to severe reflux at baseline. Best Practice Advice 7: Lack of response to aggressive acid suppressive therapy combined with normal pH testing off therapy or impedance-pH testing on therapy significantly reduces the likelihood that reflux is a contributing etiology in presenting extraesophageal symptoms. Best Practice Advice 8: Surgical fundoplication is discouraged in those with extra esophageal reflux symptoms unresponsive to aggressive PPI therapy. Best Practice Advice 9: Fundoplication should only be considered in those with a mechanical defect (e.g., hiatal hernia), moderate to severe reflux at baseline off PPI therapy who have continued reflux despite PPI therapy and have failed more conservative non-GI treatments.

show abstract

“…Стандартным методом консервативной терапии при лечении ЛФР является применение ИПП [4,6,40]. Метаанализ, обобщивший результаты 8 исследований (370 пациентов), продемонстрировал, что ИПП эффективнее плацебо в купировании симптоматики ЛФР (ОШ 1,22; 95% ДИ 0,93-1,58) [41]. В другом метаанализе 13 рандомизированных контролируемых исследований (831 пациент) было показано, что применение ИПП приводит к более выраженному регрессу клинических проявлений ЛФР по данным опросника RSI в сравнении с плацебо (стандартизированная разница средних = 3,65; 95% ДИ 1,56-5,75) [42].…”

Section: лечениеunclassified

Laryngopharyngeal reflux: clinical significance, modern approaches to diagnosis and treatment

et al. 2019

View full text Add to dashboard Cite

Gastroesophageal reflux disease (GERD) is one of the most common pathologies in modern clinical practice. Laryngopharyngeal reflux (LPR) is considered to be an extraesophageal manifestation of GERD and is characterized by retrograde ingestion of gastric content into the larynx and pharynx, leading to recurrent otolaryngological symptoms. Classical manifestations of LPR are hoarseness, perspiration, dryness and feeling of lump in the throat, coughing. There is no «gold standard» for the diagnosis of LPR. At the same time, several instrumental methods are used in clinical practice to verify the diagnosis: laryngoscopy and EGDS are the most common, and in some cases - 24-hour pH-metry and impedancemetry. In the case of an established diagnosis of LPR, it is recommended to use a standard dosage of PPI twice a day for 3–6 months.

show abstract

Meta-analysis of the efficacy of proton pump inhibitors for the symptoms of laryngopharyngeal reflux

Cited by 35 publications

References 25 publications

Clinical and psychological characteristics in gastroesophageal reflux disease patients overlapping with laryngopharyngeal reflux symptoms

Clinical and psychological characteristics in gastroesophageal reflux disease patients overlapping with laryngopharyngeal reflux symptoms

Extraesophageal Symptoms and Diseases Attributed to GERD: Where is the Pendulum Swinging Now?

Laryngopharyngeal reflux: clinical significance, modern approaches to diagnosis and treatment

Contact Info

Product

Resources

About