The efficacy of a personalised treatment depending on the characteristics of reflux at multichannel intraluminal impedance-pH monitoring in patients with acid, non-acid and mixed laryngopharyngeal reflux.

Abstract

OBJECTIVE:

To assess the evolution of symptoms and findings of laryngopharyngeal reflux (LPR) patients according to the type of reflux (acid, non-acid, mixed and gastro-oesophageal (GERD)).

DESIGN:

Prospective uncontrolled multicentre study.

METHODS:

One hundred and six patients with LPR have been recruited from 3 European Hospitals. According to the reflux characteristics at the impedance-pH monitoring (acid, non-acid, mixed, GERD), patients received a personalised treatment based on the association of diet, pantoprazole, alginate or magaldrate for 3 months. Reflux Symptom Score (RSS) was assessed at baseline, 6 and 12 weeks post-treatment. Reflux Sign Assessment (RSA) has been used to rate laryngeal and extra-laryngeal findings at baseline and 12 weeks post-treatment. Overall success rate and the evolution of symptoms and findings were evaluated according to the LPR types.

RESULTS:

One hundred and two LPR patients (42 acid, 33 non-acid, 27 mixed, including 49 with LPR and GERD) completed the study. RSS and RSA total scores significantly improved from baseline to post-treatment time in acid, mixed and non-acid groups. The presence of GERD in addition to LPR did not impact the clinical improvement. The 3-month success rates of treatment ranged from 62% to 64%, and there were no significant differences between groups. The success rate of patients with non-acid LPR was similar to those of patients with mixed and acid LPR.

CONCLUSION:

MII-pH is useful to specify the type of LPR and the related most adequate therapeutic regimen. Non-acid or mixed LPR similarly respond to treatment than acid LPR but require a treatment based on alginate or magaldrate covering the non-acid proximal reflux events.

• Authors: Jérôme R Lechien, Francois Bobin, Vinciane Muls, Francois Mouawad, Didier Dequanter, Mihaela Horoi, Marie-Paule Thill, Alexandra Rodriguez Ruiz, Sven Saussez
• Journal: Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery (Clin Otolaryngol) Vol. 46 Issue 3 Pg. 602-613 (May 2021) ISSN: 1749-4486 [Electronic] England
• PMID: 33503317 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2021 John Wiley & Sons Ltd.

Topics

• Belgium
• Electric Impedance
• Endoscopy, Gastrointestinal
• Esophageal pH Monitoring
• Female
• France
• Humans
• Laryngopharyngeal Reflux (therapy)
• Male
• Middle Aged
• Precision Medicine
• Prospective Studies
• Severity of Illness Index