Skip to main content Accessibility help

Predictors of response to short-term proton pump inhibitor treatment in laryngopharyngeal reflux patients

  • N Siupsinskiene (a1), K Adamonis (a2), R J Toohill (a3) and R Sereika (a4)



To assess benefit from one and three months' empirical proton pump inhibitor treatment in patients with suspected laryngopharyngeal reflux, and to define pre-therapy factors which may predict success with short-term proton pump inhibitor treatment.

Study design:

Prospective, open clinical study.

Materials and methods:

One hundred adult out-patients with suspected laryngopharyngeal reflux were enrolled in the study. Laryngopharyngeal reflux patients underwent endoscopy and received omeprazole for three months. Efficacy of treatment was assessed at one and three months. Patients were classified as responders if their total symptom score had improved at least 50 per cent, their videolaryngoscopic score had improved by at least two points, and they were satisfied with the results. Pre-therapy factors assessed for an effect on omeprazole outcomes included: patient demographics, reflux symptoms, videolaryngoscopic scores, endoscopic findings, overall vocal dysfunction degree, self-rated voice handicap index, hospital anxiety and depression scale scores, and general well-being score.


Fifty-six per cent of patients were classified as responders at one month of treatment; this proportion rose to 92 per cent at three months. Those patients entering the study with a higher heartburn score showed a significant response after one month of omeprazole treatment. Non-responders were found to have significantly more anxiety than responders. Logistic regression analysis revealed these factors, plus the medication dose, as being relevant for faster response prediction. No significant association was found between pre-therapy factors and three-month response to proton pump inhibitor treatment.


Three months of proton pump inhibitor treatment twice daily is warranted for confirming suspicion of laryngopharyngeal reflux. Baseline anxiety levels and heartburn scores, and the medication dose, may be relevant factors when predicting faster response to proton pump inhibitor treatment in carefully selected patients.


Corresponding author

Address for correspondence: Dr Nora Siupsinskiene, Department of Otolaryngology, Kaunas University of Medicine, Eiveniu 2, Kaunas LT-50009, Lithuania. Fax: 370 37 326862 E-mail:


Hide All

Presented as a poster at the Annual Meeting of the American Bronchoesophagological Association, 19–20 May 2006, Chicago, Illinois, USA.



Hide All
1 Koufman, JA, Aviv, JE, Casiano, RR, Shaw, GY. Laryngopharyngeal reflux: position statement of the Committee on Speech, Voice, and Swallowing Disorders of the American Academy of Otolaryngology-Head Neck Surgery. Otolaryngol Head Neck Surg 2002;127:32–5
2 Bilgen, C, Ögüt, F, Kesimli-Dinç, H, Kirazili, T, Bor, S. The comparison of empiric proton pump inhibitor trial vs 24-hour double-probe Ph monitoring in laryngopharyngeal reflux. J Laryngol Otol 2003;117:386–90
3 Merati, AL, Ulualp, SO, Lim, HJ, Toohill, RJ. Meta-analysis of upper probe measurements in normal subjects and patients with laryngopharyngeal reflux. Ann Otol Laryngol 2005;114:177–81
4 Ford, CN. Evaluation and management of laryngopharyngeal reflux. JAMA 2005;294:1534–40
5 Johnson, DA. Workshop consensus report on the extraesophageal complications of gastroesophageal reflux disease. J Clin Gastroenterol 2000;30(suppl 3):513S
6 Vaezi, MF. Reflux-induced laryngitis (laryngopharyngeal reflux). Cur Treat Options Gastroenterol 2006;9:6974
7 Karkos, PD, Wilson, JA. Empiric treatment of laryngopharyngeal reflux with proton pump inhibitors: a systematic review. Laryngoscope 2006;116:144–8
8 Williams, RBH, Szczesniak, JC, Maclean, JC, Cole, IE, Cook, IJ. Predictors of outcome in an open label, therapeutic trial of high-dose omeprazole in laryngitis. Am J Gastroenterol 2004;99:777–85
9 Ulualp, SO, Toohill, RJ, Shaker, R. Outcomes of acid suppressive therapy in patients with posterior laryngitis. Otolaryngol Head Neck Surg 2001;124:1622
10 Park, W, Hicks, DM, Khandwala, F, Richter, JE, Abelson, TI, Milstein, C et al. Laryngopharyngeal reflux: prospective cohort study evaluating optimal dose of proton-pump inhibitor therapy and pretherapy predictors of response. Laryngoscope 2005;115:1230–8
11 Garrigues, V, Gisbert, L, Bastida, G, Ortiz, V, Bau, I, Nos, P et al. Manifestation of gastreoesophageal reflux and response to omeprazole therapy in patients with chronic posterior laryngitis: an evaluation based on clinical practice. Dig Dis Scienc 2003;48:2117–23
12 Siupsinskiene, N, Adamonis, K, Toohill, RJ. Quality of life in laryngopharyngeal reflux patients. Laryngoscope 2007;117:480–4
13 Noordzij, JP, Khidr, A, Evans, BA, Desper, E, Mittal, RK, Reibel, JF et al. Evaluation of omprazole in the treatment of reflux laryngitis: a prospective, placebo-controlled, randomized, double-blind study. Laryngoscope 2001;111:2147–51
14 Dent, J, Brun, J, Fendrick, AM, Fennerty, MB, Janssens, J, Kahrilas, PJ et al. An evidence-based appraisal of reflux disease management – the General Workshop Report. Gut. 1999;44(suppl 2):S1S16
15 Pedersen, MF, Frokjaer-Jensen, B, Pabst, F, Shutte, HK, Hacki, T, Hansen, HL. Standardizing voice range profile measurements (Phonetography/ Stimmfeldmessung). In: Kotby, MN, eds. Proceedings of the 23rd World Congress IALPCairo; Secretariat of the XXIII World Congress of IALP, Cairo, Egypt
16 Šiupšinskienė, N. Quantitative assessment of healthy voice and voice disordered by functional and organic dysphonia. Summary of research report presented for habititation. Kaunas: Kaunas University of Medicine 2003;163
17 Jacobson, BH, Johnson, A, Grywalski, C, Silbergleit, A, Jacobson, G, Benninger, M. The voice handicap index (VHI): development and validation. Am J Speech Lang Pathol 1997;6:6670
18 Zigmond, AS, Snaith, RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–70
19 Siupsinskiene, N, Adamonis, K. Diagnostic test with omeprazole in patients with posterior laryngitis. Medicina (Kaunas) 2003;39:4755
20 Gatta, L, Vaira, D, Sorrenti, G, Zucchini, S, Sama, C, Vakil, N. Meta-analysis: the efficacy of proton pump inhibitors for laryngeal symptoms attributed to gastro-oesophageal reflux disease. Aliment Pharmacol Ther 2007;25:385–92



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed