Published online Oct 6, 2019. doi: 10.12998/wjcc.v7.i19.2995
Peer-review started: March 28, 2019
First decision: May 31, 2019
Revised: September 5, 2019
Accepted: September 11, 2019
Article in press: September 11, 2019
Published online: October 6, 2019
Processing time: 185 Days and 19.3 Hours
For a long time, laryngopharyngeal reflux disease (LPRD) has been treated by proton pump inhibitors (PPIs) with an uncertain success rate.
To shed light the current therapeutic strategies used for LPRD in order to analysis the rationale in the LPRD treatment.
Three authors conducted a PubMed search to identify papers published between January 1990 and February 2019 about the treatment of LPRD. Clinical prospective or retrospective studies had to explore the impact of medical treatment(s) on the clinical presentation of suspected or confirmed LPRD. The criteria for considering studies for the review were based on the population, intervention, comparison, and outcome framework.
The search identified 1355 relevant papers, of which 76 studies met the inclusion criteria, accounting for 6457 patients. A total of 64 studies consisted of empirical therapeutic trials and 12 were studies where authors formally identified LPRD with pH-monitoring or multichannel intraluminal impedance-pH monitoring (MII-pH). The main therapeutic scheme consisted of once or twice daily PPIs for a duration ranged from 4 to 24 wk. The most used PPIs were omeprazole, esomeprazole, rabeprazole, lansoprazole and pantoprazole with a success rate ranging from 18% to 87%. Other composite treatments have been prescribed including PPIs, alginate, prokinetics, and H2 Receptor antagonists.
Regarding the development of MII-pH and the identification of LPRD subtypes (acid, nonacid, mixed), future studies are needed to improve the LPRD treatment considering all subtypes of reflux.
Core tip: The treatment of laryngopharyngeal reflux disease (LPRD) has not changed since three decades and it is based on proton pump inhibitors (PPIs). However, the superiority of PPIs over placebo is still controversial and there are a significant number of non-responder patients to treatment. The development of multichannel intraluminal pH impedance monitoring led to the identification of subtypes of LPRD including acid, nonacid and mixed LPRD. The treatment of each subtype could be different in order to have better response rate.