Discussion
This study had an objective of describing the epidemiological profile of
patients with LPRD among those with throat and voice complaints for more
than a month. Laryngopharyngeal reflux is often an underdiagnosed entity
in clinical practice especially when it falls under physicians’ care. Of
all the 1425 study participants with RFS>7, majority
(81.8%) were females contrary to what has been reported by other
studies.2,10,12
The most frequently encountered symptom in this study was globus/lump
sensation, followed by pooling of mucus on the throat and frequent
throat clearing, episodes of cough upon feeding or lying down and a
chronic irritating cough. Patients with such complaints often overlook
these symptoms. The majority of patients were initially treated as cases
with allergic triggers and thus given antihistamines and cough syrups
without relief. This calls for the need for Otorhinolaryngologists to
execute proper management of these patients to avoid prolongation of
sufferings.
The study also has shown that RSI and RFS are of importance in
establishing the diagnosis of LPRD without delays when patients seek
consultation from Otorhinolaryngologists. This tends to be in line with
what was standardized so as to design RSI and the RFS to aid in the
diagnosis of LPRD.8,11 Both scores were easily
reproducible thus aiding in the follow up of the patients and helping
monitor treatment outcomes.
The duration of treatment for LPRD to date remains unstandardized. In
our study, treatment was advocated for three months with a PPI twice a
day and antacids along with dietary and lifestyle modification.
Following three months of treatment, patients were advised to adhere to
the recommended dietary and lifestyle modification. This calls for the
urgent need to establish standardized treatment protocols for LPRD
similar to what has been practicable with GERD. Regarding response to
treatment as per our study, the results were promising and encouraging
since only 15 patients (1.05%) out of the 1425 participants failed to
show any improvement with PPIs and antacids. The few patients who came
back with relapse of symptoms after three months of treatment were put
on PPIs until resolution of symptoms was noted.’ Therefore, long-term
follow-up of patients with LPRD remain to be important during the course
of their treatment.
This was a single institutional based study and therefore the study
findings cannot be generalizable and thus a limitation of this study.