The effect of anti-reflux treatment on subjective voice measurements of patients with laryngopharyngeal reflux

2013 ◽  
Vol 127 (6) ◽  
pp. 590-594 ◽  
Author(s):  
T J Beech ◽  
G Campbell ◽  
A L McDermott ◽  
A J Batch
Keyword(s):  
Proton Pump ◽  
Speech Therapy ◽  
Laryngopharyngeal Reflux ◽  
Proton Pump Inhibitor Therapy ◽  
Reflux Symptom ◽  
Reflux Symptom Index ◽  
Symptom Scale ◽  
Symptom Index ◽  
Scale Scores ◽  
The Impact

AbstractObjective:To assess the impact of anti-reflux treatment and speech therapy on subjective voice measurements of patients with laryngopharyngeal reflux.Methods:This paper reports a prospective study of patients seen in a voice clinic over a three-year period who were being treated for laryngopharyngeal reflux. Patients were assessed at presentation using the reflux symptom index and voice symptom scale, and were reassessed at three months and six months post-treatment. Treatment entailed twice daily proton pump inhibitor therapy and speech therapy.Results:The study comprised 74 patients. The reflux symptom index and voice symptom scale scores significantly improved following treatment at both three and six months. There was a correlation between improved reflux symptom index scores and improved voice symptom scale scores.Conclusion:Treatment of laryngopharyngeal reflux with twice daily proton pump inhibitors and speech therapy resulted in improved subjective voice measurements for patients.

A Prospective Study of Clinical Outcomes in Laryngopharyngeal Reflux Diseases Following Treatment with Proton Pump Inhibitors in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (28) ◽  
pp. 2538-2543
Author(s):  
Binu Raju George ◽  
Ajayan P.V ◽  
Saify Samad
Keyword(s):  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Laryngopharyngeal Reflux ◽  
Cost Effective ◽  
Reflux Symptom ◽  
P Value ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
A Prospective Study

BACKGROUND Laryngopharyngeal reflux (LPR) is found to be a common disease encountered in Otolaryngology practice. LPR presents clinically with symptoms of laryngeal irritation, frequent throat clearing, cough, and hoarseness of voice. The main diagnostic methods currently used are Fiber-optic laryngoscopy and in some centers pH monitoring. Proton pump inhibitors (PPIs) are used and found to be cost-effective and useful for the treatment of LPR. The main objective of this study was to study the effectiveness of PPIs in alleviating the symptoms assessed using Reflux Symptom Index (RSI) score and Reflux Finding Scores (RFS). METHODS A prospective study was carried out on 100 patients attending the ENT OPD of Government Medical College and Hospital, Thrissur, Kerala. Patients were evaluated for improvement in symptoms of Laryngopharyngeal reflux disease following use of proton pump inhibitors, using Reflux symptom index and Reflux finding scores using 70 degree / flexible nasopharyngolaryngoscopy. Patients with clinical findings of LPRD with RSI score > 13 and RFS score > 7 were given a standard treatment protocol followed in our ENT department using Tab. Pantoprazole 40 mg twice daily before food and the treatment response was assessed by proper follow up at 6 weeks and 12 weeks. On each follow up visit, improvement in RSI and RFS scores with Proton pump inhibitor therapy was assessed. Data collected was then tabulated and analysed. RESULTS The study was conducted in 100 patients, 59 % of whom were females and 41 % males. Mean RSI score changed from 18.9 at the beginning to 14.5 at 6 weeks of treatment and 9.0 at 12 weeks of treatment with Proton pump inhibitor. Mean RFS score changed from 10.7 at the beginning to 8.7 at 6 weeks of treatment and to 5.9 at 12 weeks of treatment. Comparison of mean Reflux Symptom Index and mean Reflux Finding Scores before and after treatment revealed improvement and the result was statistically significant (p value < 0.001). CONCLUSIONS The use of RSI and RFS scores in the assessment of PPIs at fixed intervals is cost effective and avoids time consuming and cost intensive examinations. These scores also help in early diagnosis and long term follow up of LPR patient. Fixed time interval PPI treatment significantly improved RSI and RFS scores in LPR patients. The mean RSI score changed from 18.9 at the beginning of treatment to 14.5 at 6 weeks after treatment (p value < 0.001) and 9.0 after 12 weeks of treatment; (p value < 0.001) The mean RFS score changed from 10.7 at the beginning of treatment to 8.7 at 6 weeks after treatment (p value < 0.001) and 5.9 after 12 weeks of treatment; (p value < 0.001). KEYWORDS Laryngopharyngeal Reflux, Reflux Symptom Index, Reflux Finding Score

scholarly journals A clinical study of symptomatic profile and response in objective and subjective parameters to proton pump inhibitor in laryngopharyngeal reflux

2016 ◽  
Vol 2 (4) ◽  
pp. 238
Author(s):  
Kavitha Y. ◽  
Angshuman Dutta ◽  
Sabarigirish K. ◽  
Joish Upendra Kumar
Keyword(s):  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Laryngopharyngeal Reflux ◽  
Proton Pump Inhibitor Therapy ◽  
Common Finding ◽  
Therapeutic Trial ◽  
Dietary Recommendations ◽  
Reflux Symptom Index ◽  
Presumptive Diagnosis ◽  
Symptom Index

<p class="abstract"><strong>Background:</strong> The study was conducted to identify the various clinical presentations and findings in cases of LPR and also to study the role of proton pump inhibitor in the management of laryngopharyngeal reflux by observing the effect of proton pump inhibitor on reflux finding score (RFI) and reflux symptom index (RSI).</p><p class="abstract"><strong>Methods:</strong> A prospective, interventional, cohort study of 50 diagnosed cases of LPR with RSI &gt;13 and RFS &gt;7 (based on fibreoptic laryngoscopic findings) at the time of initial presentation was done. They were treated with a 6 month course of oral cap omeprazole (20 mg twice daily 30 minutes before meals) and followed up at 0, 4, 8 and 24 weeks for any improvement in RSI and RFS scores.  </p><p class="abstract"><strong>Results:</strong> Most frequent symptoms detected in the cases were frequent clearing of throat, dry cough and sensation of lump in the throat all of which showed significant improvement at follow up at 4 weeks. Most common finding on fibreoptic laryngoscopy was erythema and diffuse laryngeal oedema, both of which showed significant improvement on follow up.There was also a significant change in RSI and RFS after receiving Omeprazole at 4 weeks, 8 weeks and at 24 weeks duration (p &lt;0.0001).</p><p><strong>Conclusions:</strong> This study dealt mainly with study of combination of clinical features that LPR presents time line of improvement of these features with capsule omeprazole.   It is proposed that a presumptive diagnosis of LPR can be made based on the criteria of RSI and patients be given an empirical therapeutic trial including behavioral and dietary recommendations and 6 months of twice-daily proton-pump inhibitor therapy  for an excellent  clinical response.</p>

scholarly journals Dietary risk factors and therapy outcomes of swallowing-related problems in laryngopharyngeal reflux: patients’ perspectives

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Nesreen Fathi Mahmoud ◽  
Aliaa Abd El-Aziz Atta ◽  
Moamena Said Elhamouly ◽  
Ahmed Ali Abdelmonem ◽  
Samia El-Sayed Bassiouny
Keyword(s):  
Risk Factors ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Laryngopharyngeal Reflux ◽  
Reflux Symptom ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Dietary Risk Factors ◽  
Dietary Risk ◽  
Dysphagia Handicap Index

Abstract Background This was a prospective cohort that included 60 gastro-esophageal reflux disorder patients with suspected laryngopharyngeal reflux-related symptoms (e.g., sore throat, throat clearing, globus sensation, cough, dysphonia, and dysphagia). The diagnosis was confirmed using history taking, clinical laryngoscopic examination, and upper endoscopy guided by the Reflux Symptom Index (RSI). Patients were treated with proton pump inhibitors and prokinetics for 12 weeks. The aim of the current study was to explore the dietary risk factors in laryngopharyngeal reflux patients and to assess the response to therapy on swallowing-related problems by comparing the baseline pre-treatment and post-treatment values of RSI and Dysphagia Handicap index (DHI). Results Analysis of data regarding the role of diet as a risk factor for reflux revealed that 33 patients (55%) are eating meat, 56 patients (93.3%) eating fat, 45 patients (75%) eating sweet, 55 patients (91.7%) eating spicy food, 52 patients (96.7%) eating fried food, 34 patients (56.7%) drinking tea, 51 patients (85%) eating big meals, 21 patients (35%) drinking fruit juices, 54 patients (90%) eating sour foods, 51 patients (85%) eating citrus fruits, and 22 patients (36.7%) smokers. There was a statistically significant decrease in Reflux Symptom Index scores and an increase of Dysphagia Handicap Index scores after 12 weeks on proton pump inhibitors and prokinetics. Conclusion Different dietary factors were present in LPR patients. A short period of empiric anti-reflux treatment has a significant improving effect on Reflux Symptom Index and Dysphagia Handicap Index scores from baseline to 12 weeks post-treatment. Further research is needed to investigate longer times of treatment for the complete resolution of symptoms.

scholarly journals Impact on Quality of Life after Treatment with Proton Pump Inhibitor in Laryngopharyngeal Reflux

2020 ◽  
Vol 63 (11) ◽  
pp. 517-522
Author(s):  
Hae-Won Choi ◽  
Hyun-Woong Jun ◽  
Jin Hyuk Jung ◽  
Moo Keon Kim ◽  
Kyung Tae ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Proton Pump Inhibitor ◽  
Proton Pump ◽  
Laryngopharyngeal Reflux ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Significant Impairment ◽  
Eortc Qlq ◽  
The Impact

Background and Objectives Several studies have assessed the impact of laryngopharyngeal reflux disease (LPRD) on the health-related quality of life (HR-QoL), showing significant impairment of HR-QoL. This study aims to assess the impact of proton pump inhibitor (PPI) treatment of LPRDs to enhance HR-QoL.Subjects and Method We prospectively collected data from LPRD patients from April 2017 to July 2019. Patients who have reflux symptom index (RSI) of ≥13 or reflux finding score (RFS) of ≥7 were enrolled in this study. We assessed HR-QoL using a questionnaire with EORTC QLQ-H&N35, -C30 on the first visit. Patients were treated with PPI (Ilaprazole 20 mg/day) on their visits at 4, 8, and 12 weeks. RSI and RFS were measured at each visit and HR-QoL was reevaluated on the last visit.Results Ninety-five patients completed the 3-months follow-up and were enrolled in this study. Female : male ratio was 71:24 and the mean age was 57.0±11.9 (27-80). The initial RSI and RFS were 16.3±8.8 and 12.6±2.9, respectively, but were changed to 11.1±9.7 and 9.7±2.6 (p<0.001 in both) at 12 weeks after the treatment. Global health status/QoL, speech problem, dry mouth, and coughing were significantly improved.Conclusion PPI administration is effective in treating LPRD, where effects begin to appear at 4 weeks after treatment. HR-QoL was also improved in patients who have RSI improvement.

scholarly journals Lansoprazole for persistent throat symptoms in secondary care: the TOPPITS RCT

2021 ◽  
Vol 25 (3) ◽  
pp. 1-118
Author(s):  
Janet A Wilson ◽  
Deborah D Stocken ◽  
Gillian C Watson ◽  
Tony Fouweather ◽  
Julian McGlashan ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Proton Pump ◽  
Laryngopharyngeal Reflux ◽  
Index Score ◽  
Reflux Symptom ◽  
Phase Iii ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Related Quality ◽  
The Mean

Background Persistent throat symptoms are commonly attributed to ‘laryngopharyngeal reflux’. Despite a limited evidence base, these symptoms are increasingly being treated in primary care with proton pump inhibitors. Objective To assess the value of proton pump inhibitor therapy in patients with persistent throat symptoms. Design This was a double-blind, placebo-controlled, randomised Phase III trial. Setting This was a multicentre UK trial in eight UK ear, nose and throat departments. Participants A total of 346 participants aged ≥ 18 years with persistent throat symptoms and a Reflux Symptom Index score of ≥ 10, exclusive of the dyspepsia item, were recruited. Intervention Random allocation (1 : 1 ratio) to either 30 mg of lansoprazole twice daily or matched placebo for 16 weeks. Main outcome measure Symptomatic response (i.e. total Reflux Symptom Index score after 16 weeks of therapy). Results A total of 1427 patients were screened and 346 were randomised. The mean age was 52 years (standard deviation 13.7 years, range 20–84 years); 150 (43%) participants were male and 196 (57%) were female; 184 (53%) participants had a mild Reflux Symptom Index minus the heartburn/dyspepsia item and 162 (47%) had a severe Reflux Symptom Index minus the heartburn/dyspepsia item. A total of 172 patients were randomised to lansoprazole and 174 were randomised to placebo. Main outcomes A total of 267 participants completed the primary end-point visit (lansoprazole, n = 127; placebo, n = 140), of whom 220 did so between 14 and 20 weeks post randomisation (‘compliant’ group); 102 received lansoprazole and 118 received placebo. The mean Reflux Symptom Index scores at baseline were similar [lansoprazole 22.0 (standard deviation 8.0), placebo 21.7 (standard deviation 7.1), overall 21.9 (standard deviation 7.5)]. The mean Reflux Symptom Index scores at 16 weeks reduced from baseline in both groups [overall 17.4 (standard deviation 9.9), lansoprazole 17.4 (standard deviation 9.9), placebo 15.6 (standard deviation 9.8)]. Lansoprazole participants had estimated Reflux Symptom Index scores at 16 weeks that were 1.9 points higher (worse) than those of placebo participants (95% confidence interval –0.3 to 4.2; p adj = 0.096), adjusted for site and baseline severity. Secondary outcomes Ninety-five (43%) participants achieved a Reflux Symptom Index score in the normal range (< 12) at 16 weeks: 42 (41%) in the lansoprazole group and 53 (45%) in the placebo group. A total of 226 participants completed the end-of-trial follow-up visit (lansoprazole, n = 109; placebo, n = 117), of whom 181 were ‘compliant’. The mean Reflux Symptom Index scores at 12 months reduced from baseline in both groups [lansoprazole 16.0 (standard deviation 10.8), placebo 13.6 (standard deviation 9.6), overall 14.7 (standard deviation 10.2)]. A total of 87 (48%) participants achieved a Reflux Symptom Index score in the normal range at 12 months: 33 (40%) in the lansoprazole group and 54 (55%) in the placebo group. Likewise, the Comprehensive Reflux Symptom Score and Laryngopharyngeal Reflux – Health Related Quality of Life total scores and subscales all showed very similar changes in the lansoprazole and placebo cohorts at both 16 weeks and 12 months. Limitations Drop-out rate and compliance are issues in pragmatic clinical trials. The Trial Of Proton Pump Inhibitors in Throat Symptoms (TOPPITS) aimed to detect clinically relevant difference with 90% power. The 346 randomised participants reduced to 283 at the primary end point; 267 completed the primary outcome measure, 220 within the protocol time scale. Despite this, the powers to detect the clinically relevant difference in Reflux Symptom Index score at 16 weeks were 82% (compliant comparison) and 89% (pragmatic comparison). The lack of difference between lansoprazole and placebo is generalisable across NHS clinics. Conclusions Participants on lansoprazole did not report significantly better outcomes than participants on placebo on any of the three patient-reported outcome tools (Reflux Symptom Index, Comprehensive Reflux Symptom Score and Laryngopharyngeal Reflux – Health Related Quality of Life). This multicentre, pragmatic, powered, definitive Phase III trial found no evidence of benefit for patients by treating persistent throat symptoms with lansoprazole. Trial registration Current Controlled Trials ISRCTN38578686 and EudraCT number 2013-004249-17. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 3. See the NIHR Journals Library website for further project information.

A Randomized Clinical Trial of Proton Pump Inhibitors Combined with Traditional Chinese Medicine in the Treatment of Laryngopharyngeal Reflux Disease

2021 ◽  
Author(s):  
Feng Pei ◽  
Wei Jia Hu ◽  
Yi Nan Mao ◽  
Yu Liang Zhao
Keyword(s):  
Proton Pump ◽  
Reflux Disease ◽  
Laryngopharyngeal Reflux ◽  
Short Form ◽  
Therapeutic Effects ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Laryngopharyngeal Reflux Disease ◽  
Group A ◽  
Group B

Background:To explore whether combined with TCM based on classical proton pumpinhibitors PPIs therapy can achieve better efficacy for patients withlaryngopharyngeal reflux disease. Methods: There were 150 laryngopharyngeal refluxpatients enrolled and divided into three groups randomly, with 50 cases in each group.Patients in group A were treated with the proton pump inhibitor (PPI) lansoprazole.Patients in group B were treated with lansoprazole combined with Banxia Houpudecoction, and patients in group C were treated with acupuncture treatments and acombination of Chinese and Western medicine. The reflux symptom index (RSI), refluxfinding score (RFS), and quality of life (36 item short form health survey questionnaire)were assessed before and 4 and 8 weeks after treatment. Results: The RSI and RFSscores of the three groups were significantly reduced after treatment (P < 0.001). Ingroup B and C, they were lower than in group A at 8 weeks (P < 0.01). The SF 36 scoreof 3 groups increased after treatment. At both 4 and 8 weeks (P < 0.001), and patientsin groups B and C scored higher than patients in group A (P < 0.001). The total effectiverate of group B and group C was higher than that of group A (P < 0.05). Conclusion:All three treatments have therapeutic effects on the disease, but the efficacy of a PPIalone is not as good as the combined treatments’ efficacies. Moreover, PPI combinedwith Banxia Houpu decoction and/or acupuncture treatment substantially affects lifeimprovement.

scholarly journals Correlation between reflux symptom index and reflux finding score in patients with laryngopharyngeal reflux: Our experience

2016 ◽  
Vol 3 ◽  
pp. 13-17
Author(s):  
Deepthi Satish ◽  
H. C. Badari Datta ◽  
B. V. Manjula ◽  
Brinda A. Poojari ◽  
Bhaskar Reddy Molluru
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Reflux Symptom ◽  
Reflux Finding Score ◽  
Reflux Symptom Index ◽  
Symptom Index

Non-voice-related throat symptoms: comparative analysis of laryngopharyngeal reflux and globus pharyngeus scales

2010 ◽  
Vol 125 (1) ◽  
pp. 59-64 ◽  
Author(s):  
R A Cathcart ◽  
N Steen ◽  
B G Natesh ◽  
K H Ali ◽  
J A Wilson
Keyword(s):  
Laryngopharyngeal Reflux ◽  
Principal Component ◽  
Symptom Assessment ◽  
Reflux Symptom ◽  
Reflux Symptom Index ◽  
Symptom Index ◽  
Similar Symptom ◽  
Postnasal Drip ◽  
Throat Symptom ◽  
Oblimin Rotation

AbstractBackground:This study calculated the comparability of two throat symptom assessment scales devised to evaluate either laryngopharyngeal reflux or globus.Setting:United Kingdom hospital out-patient departments.Method:A total of 334 subjects, with and without throat symptoms, completed the Reflux Symptom Index and/or the Glasgow and Edinburgh Throat Scale. The following were calculated for the resultant data: Cronbach's α coefficient, principal component analysis, Kaiser normalisation, varimax and oblimin rotation, and eigenvalues.Results:Analysis of data from the Reflux Symptom Index and the Glasgow and Edinburgh Throat Scale revealed clearly similar symptom domains regarding (1) coughing and blockage, and (2) globus or postnasal drip or throat-clearing, as did combined analysis of their amalgamated items. Both instruments had good overall internal consistency (α = 0.75 and 0.81, respectively). The ‘heartburn or reflux’ item in the Reflux Symptom Index mapped poorly to each underlying factor.Discussion:The most commonly used laryngopharyngeal reflux and globus assessment questionnaires appear to detect very similar symptom clusters. The management of throat disorders may previously have been over-reliant on the presenting pattern of throat symptoms. Our findings indicate a need to revisit the traditional clinical classification of throat symptoms.

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