Association of Oral Antireflux Medication With Laryngopharyngeal Reflux and Nasal Resistance

JAMA Otolaryngol Head Neck Surg. 2017 May 1;143(5):478-483. doi: 10.1001/jamaoto.2016.4127.

Abstract

Importance: Laryngopharyngeal reflux (LPR) is thought to be a potential exacerbating factor in upper airway diseases.

Objective: To describe the effect of pharmacologic therapy of laryngopharyngeal reflux on nasal resistance.

Design, setting, and participants: Prospective observational study performed between August 30, 2014, and October 1, 2015, at a tertiary care academic center including 50 patients with Reflux Symptom Index higher than 13 and Reflux Finding Score higher than 7 and 50 controls with no history of LPR and nasal disease.

Interventions: Oral antireflux medication was given to the LPR group for 12 weeks.

Main outcomes and measures: The measurements of total nasal resistance (TNR) were performed by means of active anterior rhinomanometry technique and Nasal Obstruction Symptom Evaluation (NOSE) was assessed.

Results: The LPR group had 29 (58%) women and a median age of 41.5 years (range, 18-64 years). The control group had 27 (54%) women and a median age of 38.5 years (range, 19-63 years). After treatment, a significant decrease was observed in all parameters. The median (range) TNR scores of the LPR group before and after treatment were 0.29 (0.12-0.36) and 0.19 (0.10-0.31), respectively. The median TNR score of the control group was 0.20 (range, 0.11-0.32). Whereas the TNR scores of the LPR group were higher than those of the control group before treatment (difference, -0.77; 95% CI, -0.10 to 0.05), they were almost the same after treatment (difference, 0.01; 95% CI, -0.01 to 0.03). The median (range) NOSE scores of the LPR group before and after treatment were 0.29 (0.12-0.36) and 0.19 (0.10-0.31), respectively. The median NOSE score of the control group was 0.20 (range, 0.11-0.32).

Conclusions and relevance: In this study, laryngopharyngeal reflux had a negative effect on nasal resistance and nasal congestion. Treatment was associated with improved subjective and objective nasal findings.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Airway Resistance / drug effects*
  • Case-Control Studies
  • Female
  • Humans
  • Laryngopharyngeal Reflux / drug therapy*
  • Male
  • Middle Aged
  • Nasal Cavity*
  • Prospective Studies
  • Proton Pump Inhibitors / therapeutic use*
  • Rhinomanometry
  • Surveys and Questionnaires

Substances

  • Proton Pump Inhibitors