A review of a combined gastroenterology and laryngology clinic was conducted to determine the effectiveness of treatment and the predictive value of clinical findings and investigations. Data were collected prospectively. Investigations were performed according to clinical criteria. Patients with symptoms suspected to be due to
laryngopharyngeal reflux (based on a positive oesophageal pH test and/or changes on videolaryngoscopy consistent with posterior
laryngitis) were treated with
omeprazole for at least two to three months. There were 87 patients; the most common symptoms were
cough (38 per cent) and
hoarseness (36 per cent); 77 per cent had some symptoms suggestive of
gastro-oesophageal reflux. Sixty-seven patients were given
omeprazole. A good response to laryngo-pharyngeal symptoms was seen in 37 patients (55 per cent). The presence of reflux symptoms was not a predictor of a good response. Increasing severity of oesophageal
acid exposure over the 24 hours of pH testing was associated with a better symptom response (Spearman rank correlation, p = 0.01). Posterior
laryngitis was not associated with the response to treatment, although there was a trend towards an association between improvement in
laryngitis (
after treatment) and improvement in symptoms (p = 0.08). The response to
proton pump inhibitors was lower than other published results. Oesophageal pH monitoring may have a role in predicting which patients will respond to
proton pump inhibitors. This study does not support the decision to treat with anti-secretory
therapy, based only on the presence of posterior
laryngitis.