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Int Arch Otorhinolaryngol 2014; 18(02): 184-191
DOI: 10.1055/s-0033-1352504
Review Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Laryngopharyngeal Reflux: Diagnosis, Treatment, and Latest Research

Andrea Maria Campagnolo
1   Department of Otolaryngology, Hospital Universitário Pedro Ernesto (HUPE), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro/RJ, Brazil
,
Jaqueline Priston
2   Department of Speech-Language Pathology (SLP), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro/RJ, Brazil
,
Rebecca Heidrich Thoen
1   Department of Otolaryngology, Hospital Universitário Pedro Ernesto (HUPE), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro/RJ, Brazil
,
Tatiana Medeiros
2   Department of Speech-Language Pathology (SLP), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro/RJ, Brazil
,
Aída Regina Assunção
1   Department of Otolaryngology, Hospital Universitário Pedro Ernesto (HUPE), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro/RJ, Brazil
› Author Affiliations
Further Information

Publication History

14 December 2012

06 June 2013

Publication Date:
05 November 2013 (online)

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Abstract

Introduction Laryngopharyngeal reflux (LPR) is a highly prevalent disease and commonly encountered in the otolaryngologist's office.

Objective To review the literature on the diagnosis and treatment of LPR.

Data Synthesis LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Molecular studies have tried to identify biomarkers of reflux such as interleukins, carbonic anhydrase, E-cadherin, and mucin.

Conclusion Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

Keywords

laryngopharyngeal reflux - laryngoscopy - esophageal pH monitoring - proton pump inhibitors - biomarkers - pharmacologic
 

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