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

Published online by Cambridge University Press:  11 March 2008

N Siupsinskiene ,
K Adamonis ,
R J Toohill  and
R Sereika
N Siupsinskiene*
Affiliation:
Departments of Otolaryngology, Kaunas University of Medicine, Lithuania
K Adamonis
Affiliation:
Gastroenterology, Kaunas University of Medicine, Lithuania
R J Toohill
Affiliation:
Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
R Sereika
Affiliation:
Alytus S. Kudrika Hospital, Alytus, Lithuania
*
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: norai_s@yahoo.com
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Abstract

Objectives:

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.

Results:

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.

Conclusion:

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.

Keywords

Gastro-Oesophageal RefluxProton Pump Inhibitors

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 11 , November 2008 , pp. 1206 - 1212
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

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

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