Proton Pump Inhibitor Therapy for Chronic Laryngo-Pharyngitis: A Randomized Placebo-Control Trial

Abstract

OBJECTIVE: To determine the efficacy of proton-pump inhibitor (PPI) therapy for chronic laryngo-pharyngitis treated with lifestyle modification. STUDY DESIGN AND METHODS: Double-blind, randomized trial comparing two-month Rabeprazole (20 mg b.i.d.) to placebo control. RESULTS: Compared to baseline, both PPI and control patients had significant improvement in total reflux symptoms ( P = 0.002 and P = 0.03 respectively), with significant improvement in “laryngo-pharyngeal” but not “typical” reflux symptoms. No significant difference was noted for change in reflux symptoms between PPI-treated and control patients ( P = 0.44). Significant global improvement was noted by 50% of control and 53% of PPI-treated patients ( P = 1.0). No significant differences were noted within or between treatment groups for change in health status or videostrobolaryngoscopy grade. Lifestyle modification compliance correlated significantly with global improvement. CONCLUSION: Compared to baseline, lifestyle modification for 2 months significantly improved chronic laryngo-pharyngitis symptoms. When compared to control, treatment with a PPI failed to demonstrate significantly greater improvement in reflux symptoms, health status, or laryngeal appearance.