Prospective, observational study using rabeprazole in 455 patients with laryngopharyngeal reflux disease

Abstract

The role of proton pump inhibitor in the treatment of laryngopharygneal reflux disease (LPRD) has been advocated, but there has been few reports dealing with large population based on time-related efficacy of rabeprazole. It was designed to assess the efficacy of rabeprazole and to evaluate which symptoms or findings varied significantly as medication sustained. Multiorgan, open-label cohort, prospective observational study was designed. We identified 1,142 patients with LPRD, and enrolled 455 patients, who participated fully in this survey and follow-up observation for 12 weeks. Reflux symptom index (RSI) and reflux finding score (RFS) were used to evaluate therapeutic efficacy. These parameters were evaluated at the 4th, 8th, and 12th weeks, respectively. Valid rate was used to explain improved proportion of patients after medication. The most common symptom was a globus sense in the throat. Posterior commissure hypertrophy was the most frequently encountered laryngoscopic finding. Female patients complained of heartburn and chest pain more than did male patients (P < 0.001), whereas male patients showed ventricular obliteration and erythematous changes more frequently than did female patients (P < 0.001). By RSI evaluation, scores gradually declined. Each item of the RSI improved at every visit (P < 0.001). Total RFS decreased progressively for 12 weeks and similar results were seen when every RFS item was individually examined. The proportion of patients who showed RSI and RFS falling by more than 50% after medication increased gradually as follow-up continued. This trend seemed to be significant (P < 0.001). Side effects of therapy were minimal. Despite the some constraints of an observational study, rabeprazole appeared to improve LPRD symptoms and signs. Prolonged medication at least 3 months may be beneficial to LPRD patients. Long-term medication effects require further evaluation.

Prevalence of voice & swallowing complaints in Pre-operative thyroidectomy patients: a prospective cohort study

“…As such, we administered the RSI to our patients and found that 33.9% of pre-operative thyroidectomy patients had concomitant laryngopharyngeal reflux, which is in keeping with reported LPR rates in the general population [9][10][11]. However, when we looked specifically at the relative contribution of LPR to voice and swallowing complaints in this cohort we found that laryngopharyngeal reflux may account for a larger proportion of patients with elevated symptom scores.…”

“…Due to the non-specific nature of these complaints, and the possibility of other underlying etiologies, the true prevalence of voice and swallowing symptoms due to thyroid pathology remains unclear. These same symptoms are common in the general population, and are often attributed to and relieved with treatment for laryngopharyngeal reflux (LPR) [9][10][11]. Currently there is very limited literature examining the prevalence of laryngopharyngeal reflux in thyroidectomy patients.…”

Clinical Predictors for Response to Proton Pump Inhibitor Treatment in Patients With Globus

“…In contrast, a recent non placebo-controlled study showed PPI efficacy of improving LPR (including globus) symptoms and signs using large scaled patients 12. In addition, few data on clinical predictors of symptom response to PPIs in patients with globus has been reported.…”

Instruments evaluating the clinical findings of laryngopharyngeal reflux: A systematic review

“…According to some U.S. reports, LPRD affects approximately 10% of outpatients of the ear, nose, and throat (ENT) department consultation and up to 50% of patients in the voice center . The most common complaints related to LPRD include hoarseness, sore throat, odynophagia, cough, throat clearing, globus sensation, and excessive phlegm . Usual gastroesophageal reflux disease (GERD) findings such as heartburn, regurgitations, and esophagitis do not necessarily concern the majority of patients, leading some otolaryngologists to distinguish LPR and GERD as two different clinical entities .…”