Proton pump inhibitors as treatment of laryngeal disorders among patients with gastroesophageal reflux disease: a single-arm (pre and post) quasi-experimental study

Abstract

BackgroundLaryngopharyngeal reflux is a silent cause of laryngeal disorders which was documented in the last decade by many studies. This study aimed to evaluate the prevalence of laryngeal reflux in GERD cases and to evaluate the effect of GERD treatment on these laryngeal disorders.MethodologyIn this single-arm (pre and post) quasi-experimental study, eighty patients with GERD were examined for laryngeal disorders by rigid laryngoscopy and assessed by the Reflux Finding Score (RFS). Complaints of patients were evaluated using the 9-item Reflux Symptom Index (RSI) questionnaire. Patients received medical treatment of GERD in the form of proton pump inhibitors (PPIs) only, and they were reassessed after 3 months for improvement in their symptoms and signs using RSI and RFS systems to compare patient complaints and findings in the laryngeal endoscopy pre- and post-treatment.ResultsAmong 80 confirmed GERD cases, 70 (87.5%) suffered from laryngeal disorders. Throat clearing and postnasal drip were the most prevalent symptoms, and ventricular obliteration and erythema, vocal fold and diffuse laryngeal edema, and posterior commissure hypertrophy were the most detected signs. Significant improvement in both symptoms and signs after 3 months of PPI therapy was clearly observed. The resistance rate among our studied patients was reported to be 22.4%.ConclusionGERD can be considered as an inducer or cause of laryngeal disorders, with a significant direct proportional relationship between the severity of GERD and both the RSI and RFS. PPI greatly improves laryngeal disorders among GERD patients with a high response rate (77.6%).