Journal article
Evaluation and Management of Laryngopharyngeal Reflux Disease: An Updated State of the Art Review
Otolaryngology-head and neck surgery, Forthcoming
26 Aug 2026
PMID: 42647076
Abstract
To review the updated literature about epidemiology, clinical presentation, diagnosis, and treatment of laryngopharyngeal reflux disease (LPRD) and to provide a practical management for clinical practice.
PubMED, Cochrane Library, and Scopus.
Four authors conducted the literature review on LPRD epidemiology, clinical presentation, diagnosis, and treatment according to the PRISMA statement. A critical analysis of the literature and a related management algorithm for clinical practice were provided.
Studies from the last 5 years provided increased evidence about the gaseous and alkaline profile of LPRD at 24-hour hypopharyngeal-esophageal impedance-pH monitoring, and the presence of alkaline-activated enzymes in the upper aerodigestive tract mucosa. Three consensuses emerged, emphasizing the importance of objective testing to demonstrate LPRD in patients with laryngopharyngeal symptoms. The recent literature suggested that LPRD may be associated with atypical presentations, including posterior nasal inflammation, dry eyes, and middle ear disorders. The predominantly alkaline nature of LPRD has prompted clinical studies supporting alginate and magaldrate over proton pump inhibitors (PPIs), which only target gastric acidity, for managing acid, weakly acid, and alkaline pharyngeal reflux events. Despite a growing literature, there was no randomized controlled trial comparing alginate, magaldrate, diet, and PPIs conducted in the last 5 years.
The increased evidence about alkalinity of pharyngeal reflux events and the detection of alkaline-activated enzymes in saliva may shift the current PPI-based therapy to alginate therapy. Multicenter international randomized controlled studies with standardized protocols could improve the scientific knowledge about LPRD.
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Details
- Title
- Evaluation and Management of Laryngopharyngeal Reflux Disease: An Updated State of the Art Review
- Creators
- Jerome R Lechien (Corresponding Author) - University of MonsNikki Johnston - Medical College of WisconsinEdoardo Savarino - University of PaduaAbdul Latif Hamdan - American University of Beirut Medical CenterMaria Rosaria Barillari - University of Naples Federico IIJonathan M Bock - Medical College of WisconsinYoung-Gyu Eun - Kyung Hee UniversityJinrang Li - Chinese PLA General HospitalMichael F Vaezi - Vanderbilt University Medical CenterJacqueline E Allen - University of AucklandKarol Zelenik - University Hospital OstravaPeter C Belafsky - University of California Davis Medical CenterGiovanni Dapri - Humanitas GavazzeniClaudia A Eckley - Fleury S.A. (Brazil)Toshitaka Hoppo - Johnson UniversityRobert T Sataloff - Drexel UniversityLee M Akst - Johns Hopkins UniversityAntonino Maniaci - Università degli Studi di Enna KoreLuigi A Vaira - University of SassariPetros D Karkos - AHEPA University HospitalWalter W Chan - Brigham and Women's HospitalInna A Husain - Indiana University HealthThomas L Carroll - Harvard University
- Publication Details
- Otolaryngology-head and neck surgery, Forthcoming
- Publisher
- Wiley
- Number of pages
- 22
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- College of Medicine; Otolaryngology (and Head and Neck Surgery)
- Web of Science ID
- WOS:001860146100001
- Other Identifier
- 991022203297104721