Laryngopharyngeal reflux
Abstract
Background: In 4–10 % of patients with gastroesophageal reflux (GER) some atypical symptoms are found (cough, hoarseness, globus pharyngeus, dyspnea) which are characteristic for laryngopharyngeal reflux (LPR). The signs of LPR can be detected in more than 50 % of dysphonic patients. In the diagnostics of LPR, a meticulous history and a videoendoscopy of the larynx and pharynx are the most important procedures. The diagnosis of LPR can be confirmed by the 24-hour double probe pH monitoring and the treatment test with proton pump inhibitors. The best diagnostic results can be obtained with a combination of several diagnostic procedures.
Conclusions: An otorhinolaryngologist can start a treatment test with proton pump inhibitors in a patient in whom a laryngopharyngeal reflux is suspected on the basis of history and laryngopharyngeal endoscopy. A successful treatment requires at least 12 weeks regimen with high doses 20 mg twice a day. In the case of alarm signs and unsuccessful treatment a gastroenterologic intervention is necessary.
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References
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