Review article: Diagnosis and management of laryngopharyngeal reflux

Abstract

SummaryBackgroundLaryngopharyngeal reflux has classically referred to gastroesophageal reflux leading to chronic laryngeal symptoms such as throat clearing, dysphonia, cough, globus sensation, sore throat or mucus in the throat. Current lack of clear diagnostic criteria significantly impairs practitioners' ability to identify and manage laryngopharyngeal reflux.AimsTo discuss current evidence‐based diagnostic and management strategies in patients with laryngopharyngeal reflux.MethodsWe selected studies primarily based on current guidelines for gastroesophageal reflux disease and laryngopharyngeal reflux, and through PubMed searches.ResultsWe assess the current diagnostic modalities that can be used to determine if laryngopharyngeal reflux is the cause of a patient's laryngeal symptoms, as well as review some of the common treatments that have been used for these patients. In addition, we note that the lack of a clear diagnostic gold‐standard, as well as specific diagnostic criteria, significantly limit clinicians' ability to determine adequate therapies for these patients. Finally, we identify areas of future research that are needed to better manage these patients.ConclusionsPatients with chronic laryngeal symptoms are complex due to the heterogenous nature of symptom pathology, inconsistent definitions and variable response to therapies. Further outcomes data are critically needed to help elucidate ideal diagnostic workup and therapeutic management for these challenging patients.

Diagnostic Value of Fasting and Bedtime Saliva Pepsin Measurements in Laryngopharyngeal Reflux

“…The clinical diagnosis of LPR is challenging regarding the non-specificity of symptoms and signs and the low therapeutic success rate of empirical treatment [15][16][17][18][19]. HEMII-pH is considered as the most reliable tool, but this approach remains expensive and poorly tolerated by patients [8].…”