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Laryngopharyngeal reflux disease: clinical presentation, diagnosis and therapeutic challenges in 2018.

TitleLaryngopharyngeal reflux disease: clinical presentation, diagnosis and therapeutic challenges in 2018.
Publication TypeJournal Article
Year of Publication2018
AuthorsLechien, J. R., Saussez S., & Karkos P. D.
JournalCurr Opin Otolaryngol Head Neck Surg
Volume26
Issue6
Pagination392-402
Date Published2018 Dec
ISSN1531-6998
KeywordsHumans, Laryngopharyngeal Reflux
Abstract

PURPOSE OF REVIEW: To review the recent literature on presentation, diagnosis and treatment of laryngopharyngeal reflux.
RECENT FINDINGS: Patients with laryngopharyngeal reflux have a higher risk for gastroesophageal reflux and respiratory-related diseases. Many symptoms and findings are underestimated, contributing to the inconclusive results of many therapeutic trials. Additionally, little significance is given to nonacid and mixed refluxates, although a significant prevalence. The association between symptoms, signs, impedance-pH studies and pepsin detection could be the most accurate way for a clear diagnosis. 'Reflux profiling' is also important for the administration of a personalized treatment based on diet, proton pump inhibitors, alginate, magaldrate and other second-line drugs. There are only a handful of studies focusing on the addition of alginate or magaldrate to the treatment of laryngopharyngeal reflux, although their contribution has extensively been demonstrated.
SUMMARY: Diagnosis remains controversial despite improvement in impedance and availability of pepsin detection in daily practice. With recent studies exhibiting a significant prevalence of nonacid or mixed refluxes, the addition of alginate or magaldrate to proton pump inhibitors should be considered. Future studies are needed to assess these new therapeutic schemes in moderate and severe laryngopharyngeal reflux.

DOI10.1097/MOO.0000000000000486
Alternate JournalCurr Opin Otolaryngol Head Neck Surg
PubMed ID30234664

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