THE IMPACT OF PROTON PUMP INHIBITORS ON LARYNGOPHARYNGEAL REFLUX DISEASE
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Keywords
Laryngopharyngeal reflux, gastroesophageal reflux, proton pump inhibitors, rabeprazole, reflux symptom index, reflux finding score.
Abstract
Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of gastroesophageal reflux characterized by throat symptoms (hoarseness, chronic cough, globus). Proton pump inhibitors (PPIs) are first-line therapy, but evidence for their efficacy in LPR is mixed.
Objective: We evaluated the clinical impact of a PPI regimen on LPR symptoms and findings in a prospective interventional study.
Methods: One hundred adult patients with confirmed LPR (Reflux Symptom Index (RSI) ≥13 and Reflux Finding Score (RFS) >7) were enrolled. All received Rabeprazole 20 mg twice daily for 6 weeks. RSI and RFS were recorded before and after therapy. Secondary analyses assessed the influence of lifestyle factors (smoking, alcohol, diet). Data were analyzed using paired t-tests for RSI (normally distributed) and Wilcoxon signed-rank tests for RFS (non-normally distributed). A p-value <0.05 was considered statistically significant.
Results: Treatment yielded marked improvements. Mean RSI fell from 21.28 to 9.38 and mean RFS from 10.2 to 3.2 (both p<0.001). All individual RSI and laryngoscopic findings improved (p<0.001). Smokers experienced significantly less RFS improvement than non-smokers (p<0.05); alcohol use and diet did not significantly alter outcomes.
Conclusion: 6 weeks of high-dose rabeprazole significantly alleviated LPR symptoms and laryngeal findings in this study. The data support PPIs as an effective component of LPR management, though residual symptoms in some patients – especially smokers – highlight the importance of lifestyle modification and adjunctive therapies.
Keywords:
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Dr Nishant Gupta
Postgraduate in Department of ENT & HNS, Adichunchanagiri Medical College, BG Nagara, Karnataka,
Dr Rohini Urs
Assistant Professor in Department of ENT & HNS, Adichunchanagiri Medical College, BG Nagara, Karnataka,
Dr Reshma S
Senior Resident in Department of ENT & HNS, Adichunchanagiri Medical College, BG Nagara, Karnataka,
Sumayya Fatima
Postgraduate in Department of ENT & HNS, Adichunchanagiri Medical College, BG Nagara, Karnataka
Jasoliya Arshwiben Arvindbhai
Postgraduate in Department of ENT & HNS, Adichunchanagiri Medical College, BG Nagara, Karnataka,
Dr Ravi KS
Professor in Department of ENT & HNS, Adichunchanagiri Medical College, BG Nagara, Karnataka