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VOLUME 15 , ISSUE 3 ( September-December, 2023 ) > List of Articles
Ram Kumar, Preethi Umamaheswaran, Deepakraj Venkatesan, Sriram Ramamurthy
Keywords : Gastroesophageal reflux disease, Laryngoscopy, Laryngopharyngeal reflux
Citation Information : Kumar R, Umamaheswaran P, Venkatesan D, Ramamurthy S. Revisiting the Clinical Practices in Laryngopharyngeal Reflux Disease; Measures that Decrease the Duration of Treatment. Int J Otorhinolaryngol Clin 2023; 15 (3):107-110.
License: CC BY-NC 4.0
Published Online: 09-01-2024
Copyright Statement: Copyright © 2023; The Author(s).
Introduction: Laryngopharyngeal reflux (LPR) is a very common disease seen in the ENT outpatient department. Reflux symptom index (RSI) and Reflux findings score (RFS) are used to diagnose LPR clinically. The treatment of LPR includes dietary and behavioral modifications for all patients in addition to pharmacotherapy. This study aims to revisit the clinical practices followed in the treatment of LPR and to find out measures that decrease the duration of treatment. Materials and methods: An interventional study was conducted on 50 patients who presented with reflux symptoms. Reflux symptom index and RFS were used to diagnose LPR. Patients started on treatment with the tablet rabeprazole 20 mg twice daily for 6 weeks along with proper counseling regarding lifestyle modification (LSM). Patients were asked to review after 3 weeks and divided into two groups. They were reviewed again at the end of 6 weeks and treatment response was assessed. Patients were divided into two groups with group A having patients who followed the pharmacotherapy and LSM advice without deviation, group B having patients with poor treatment compliance by not following LSM measures. Treatment response was assessed using RSI and RFS. An independent sample t-test was applied to compare the pretreatment and posttreatment RSI and RFS and the results were tabulated. Results: The mean RSI was found to be 12.23 in group A and 12.41 in group B before starting treatment. The mean posttreatment RSI was found to be 6.27 in group A and 8.36 in group B. The mean difference in RSI between the pretreatment and posttreatment values was found to be 5.95 in group A and 4.05 in group B. Independent t-test was applied for the mean difference in RSI and the p-value was found to be 0.002. The mean RFS was 6.73 in group A and 6.77 in group B before starting treatment. The mean posttreatment RFS was 4.09 in group A and 4.55 in group B. The mean difference in RFS was found to be 2.64 in group A and 2.23 in group B. Independent sample t-test was applied for the mean difference in RFS and the p-value was found to be 0.372. Conclusion: Reflux symptom index is found to be a sensitive index of prognosis of LPR and it can be used in monitoring the prognosis of patients undergoing treatment in the outpatient clinic. From our study, we have observed that patients who followed LSM measures effectively had a significant improvement in reflux symptoms sooner than patients who did not follow LSM measures. Lifestyle modifications alone do not suffice in the treatment of LPR. A combination of both, with effective counseling, is needed for the successful treatment of LPR.