Does PPI Therapy Normalize pH in Laryngopharyngeal Reflux Patients?

Friedman M, Pott TR, Waxman J. Otolaryngol Head Neck Surg. 2013;149:84.


OBJECTIVES: Laryngopharyngeal reflux (LPR) is commonly treated with twice-daily proton pump inhibitor (PPI) therapy. However, a significant number of patients do not achieve complete resolution of symptoms. In this study, we aimed to assess the effect of twice-daily PPI treatment on the oropharyngeal pH environment in patients with pH-probe confirmed LPR.

RESULTS: 34 women and 22 men were assessed pre- and post-treatment, with age of 51.9 } 16.8 years and BMI of 30.8 } 7.0 kg/m2 (mean } SD). Pre-treatment upright and supine Ryan scores were 142.3}161.9 and 14.21 } 17.14, respectively (mean }SD). Patients were treated with twice-daily PPIs for a duration of 105.7 } 88.2 days (mean } SD). Post-treatment upright and supine Ryan scores were 72.66}140.5 and 12.27 } 21.1, respectively (mean }S D). Paired T-tests showed a significant decrease in mean post-treatment upright Ryan scores (P = 0.0003). However, post-treatment Ryan scores normalized in only 26 subjects (46.4%). RSI scores were higher in non-responders.

CONCLUSION: While PPI therapy resulted in a significant decrease in mean upright Ryan score, the Ryan score was normalized in only 46.4% of patients. This suggests that twice daily PPIs may be insufficient to completely eliminate reflux and symptoms of LPR.

 

Topics: pH monitoring, PPI, 2013

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