Abstract
The aim of this article is to introduce Lithuanian clinical practice guidelines for the management of laryngopharyngeal form of gastroesophageal reflux disease for standardization of the diagnosis and treatment of the disease and prevention of its complications. Composed guidelines provide recommendations for primary care physicians as well as otorhinolaryngologists and gastroenterologists for the management of adults with uncomplicated laryngopharyngeal form of gastroesophageal reflux disease. Committee composed of experts from Lithuanian Otorhinolaryngological and Gastroenterological Societies developed guidelines based on a comprehensive review of the evidence-based literature related to laryngopharyngeal form of gastroesophageal reflux disease and guidelines of other countries. The guidelines provide description of each medicine groups with emphasis on proton pump inhibitors as the most effective drugs for the treatment of laryngopharyngeal form of gastroesophageal reflux disease. Indications for empirical treatment with proton pump inhibitors are described, as well as duration of treatment, doses, optimal regimen of use, and assessment of treatment efficacy. The therapy should begin with the application of proton pump inhibitors twice daily, before meal for three months. Combined therapy for nonresponders is described. Algorithm for stopping the medication is recommended. These recommendations may provide an efficient and economical approach to the management of this problem.
Highlights
Committee composed of experts from Lithuanian Otorhinolaryngological and Gastroenterological Societies developed guidelines based on a comprehensive review of the evidence-based literature related to laryngopharyngeal form of gastroesophageal reflux disease and guidelines of other countries
The therapy should begin with the application of proton pump inhibitors twice daily, before meal for three months
Workshop consensus report on the extraesophresponse of diagnostic treatment with proton pump inhibitors ageal complications of gastroesophageal reflux disease
Summary
Šiuolaikinis požiūris į gastroezofaginio refliukso ligos laringofaringinės formos gydymą. Raktažodžiai: gastroezofaginio refliukso ligos laringofaringinė forma, konservatyvus gydymas, protonų siurblio inhibitoriai, diagnostinis gydymas, gydymo rekomendacijos. Apžvelgti Lietuvos gastroezofaginio refliukso ligos laringofaringinės formos suaugusiųjų gydymo nuorodas, skirtas otorinolaringologams, gastroenterologams ir šeimos gydytojams siekiant pagerinti ligos diagnostiką ir gydymą, sumažinti ligos komplikacijų skaičių. Pagrindiniai vaistai yra protonų siurblio inhibitoriai, kurių skiriama du kartus per dieną prieš valgį. Ypač gastroezofaginio refliukso ligos laringofaringinės formos (GERL LF) gydymas, kuris per pastarąjį dešimtmetį pasikeitė iš esmės. Kad patys veiksmingiausi vaistai yra protonų siurblio inhibitoriai (PSI), kurių skiriama diagnozuoti ir gydyti ligą (3, 4). Protonų siurblio inhibitoriai (PSI) yra pirmojo pasirinkimo vaistai GERL LF gydyti. Indikacijos: kombinuotas gydymas skiriant vaistą kartu su protonų siurblio inhibitoriais, kai nustatomas refliuksinis laringitas (difuzinė gerklų edema, netikra balso klosčių vaga (pseudosulcus vocalis), užpakalinės gerklų dalies III–IV laipsnio hiperplazija), granuliomos ir nėra naktinio rūgšties proveržio simptomų.
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