Outcomes of Antireflux Therapy for the Treatment of Chronic Laryngitis

Author:

Hanson David G.1,Kamel Perry L.1,Kahrilas Peter J.1

Affiliation:

1. Chicago, Illinois

Abstract

This study examined outcomes of antireflux and antacid treatment for the signs and symptoms of chronic laryngitis. Patients from a referral institutional practice with chronic laryngitis symptoms, without other apparent causes of laryngeal inflammation, were followed up and examined at progressive stages of antireflux treatment as a case series outcome study. The cases included unselected individuals with a diagnosis of chronic (>3 months' duration) laryngitis. Patients with chronic throat complaints were treated with nocturnal antireflux precautions, with addition of famotidine 20 mg or omeprazole 20 mg at bedtime for patients who did not respond to antireflux precautions alone. The outcome measures were resolution of symptoms, and change in findings on telescopic laryngoscopy. Chronic throat symptoms of 93 of 182 patients (51%) responded to nocturnal antireflux precautions alone. The complaints of an additional 48 patients resolved with the addition of famotidine 20 mg at bedtime to antireflux precautions (77% response). The symptoms of 34 of the remaining 41 patients responded to treatment with omeprazole 20 mg at bedtime. Therefore, symptoms of 96% of patients responded to treatment aimed at preventing reflux of gastric acid. The remaining patients with refractory symptoms had a partial response or no response or chose fundoplication. Erythema and granular mucositis were the most common laryngoscopic findings. Ulceration and granuloma formation were less common, but also responded to antireflux treatment. Some (7) patients required high doses of omeprazole or fundoplication to achieve symptomatic relief and healing of chronic inflammatory changes of the posterior larynx. Relapse of symptoms was common when treatment was stopped. This experience provides supportive evidence for a hypothesis that gastropharyngeal acid reflux is the underlying cause of posterior chronic laryngitis.

Publisher

SAGE Publications

Subject

General Medicine,Otorhinolaryngology

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1. An update on current treatment strategies for laryngopharyngeal reflux symptoms;Annals of the New York Academy of Sciences;2021-12-17

2. Results of the study of conservative treatment of laryngeal manifestations of laryngopharyngeal reflux;Meditsinskiy sovet = Medical Council;2021-12-01

3. Laryngopharyngeal reflux diagnostics: review article;Meditsinskiy sovet = Medical Council;2021-10-19

4. Review of management of laryngopharyngeal reflux disease;European Annals of Otorhinolaryngology, Head and Neck Diseases;2021-09

5. Mise au point sur le reflux laryngopharyngé;Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale;2021-09

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