Outcomes of Antireflux Therapy for the Treatment of Chronic Laryngitis

Abstract

This study examined outcomes of antireflux and antacid treatment for the signs and symptoms of chronic laryngitis. Patients from a referral institutional practice with chronic laryngitis symptoms, without other apparent causes of laryngeal inflammation, were followed up and examined at progressive stages of antireflux treatment as a case series outcome study. The cases included unselected individuals with a diagnosis of chronic (> 3 months' duration) laryngitis. Patients with chronic throat complaints were treated with nocturnal antireflux precautions, with addition of famotidine 20 mg or omeprazole 20 mg at bedtime for patients who did not respond to antireflux precautions alone. The outcome measures were resolution of symptoms, and change in findings on telescopic laryngoscopy. Chronic throat symptoms of 93 of 182 patients (51%) responded to nocturnal antireflux precautions alone. The complaints of an additional 48 patients resolved with the addition of famotidine 20mg at bedtime to antireflux precautions (77% response). The symptoms of 34 of the remaining 41 patients responded to treatment with omeprazole 20 mg at bedtime. Therefore, symptoms of 96% of patients responded to treatment aimed at preventing reflux of gastric acid. The remaining patients with refractory symptoms had a partial response or no response or chose fundoplication. Erythema and granular mucositis were the most common laryngoscopic findings. Ulceration and granuloma formation were less common, but also responded to antireflux treatment. Some (7) patients required high doses of omeprazole or fundoplication to achieve symptomatic relief and healing of chronic inflammatory changes of the posterior larynx. Relapse of symptoms was common when treatment was stopped.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative study of omeprazole, lansoprazole, pantoprazole and esomeprazole for symptom relief in patients with reflux esophagitis

“…Recently, PPI has been also used for the diagnosis of gastroesophageal reflux, not only in the patients with non-erosive reflux disease (NERD) [28,29] , but also in patients with atypical gastroesophageal reflux symptoms [30,31] . The present study suggests that the four kinds of PPI are effective for the diagnosis of the existence of gastroesophageal acid reflux, and it may be worthwhile investigating whether esomeprazole can shorten the time period necessary for diagnosis.…”

The importance of voice analysis in evaluating the effectiveness of reflux treatment

“…According to these data, finding scores declined earlier than symptom scores in our patient group, and this is contradictory to other studies in literature. [29,30] But RFS and RSI average score differences were statistically significant before and after treatment at first and third month.…”

Management of laryngopharyngeal reflux with proton pump inhibitors

“…Recommendations of treatment with PPIs in suspected LPR are based on the results of a number of open label studies (Kamel et al 1994;Hanson 1995;Jaspersen et al 1996;Habermann et al 1999;Shaw and Searl 1997;Wo et al 1997;Ulualp et al 2001;Delgaudio and Waring 2003;Park et al 2005;Siupsinskiene et al 2007). These are all uncontrolled studies investigating the effect of a PPI at varying doses on symptoms and laryngeal fi ndings with treatment lasting from 6 to 24 weeks.…”