title: Effects of Proton Pump Inhibitor Therapy for Laryngopharyngeal Reflux on Posttreatment Symptoms and Hypopharyngeal pH.
abstract: To determine the effect of twice-daily proton pump inhibitor (PPI) treatment on the relationship between laryngopharyngeal pH environment and symptoms in patients with laryngopharyngeal reflux (LPR).
  
  
  
  Retrospective analysis of records from consecutive patients seen at a single clinical site between 2009 and 2012.
  
  
  
  Forty-three records of patients diagnosed with LPR who underwent pre- and posttreatment pH studies were included. Prior to treatment, all had a Reflux Symptom Index (RSI) > 13 and an abnormal pH study. Patients were treated for ≥ 4 weeks with twice-daily PPIs. Following treatment, patients completed a second RSI and pH study.
  
  
  
  Most patients (67.4%) had symptom normalization; however, most patients (60.5%) did not have pH normalization. For all patients whose symptoms did not normalize, pH scores also did not normalize; 32.6% of patients showed no subjective or objective treatment response. For individuals whose symptoms normalized but whose pH scores did not normalize, there was a significant decrease in upright pH score. For the entire group, pretreatment symptom and upright pH scores were strongly positively correlated. Improvements in symptom and upright pH scores following treatment were moderately positively correlated.
  
  
  
  Laryngopharyngeal pH failed to normalize for most individuals after PPI treatment; only pH improvement was necessary for symptom normalization. Many patients had no treatment response. Laryngopharyngeal reflux patients may make up a heterogeneous group, and PPI responsivity may help explain conflicting results from previous studies. Posttreatment pH monitoring is recommended in studies investigating the efficacy of PPI therapy for LPR.
authors.affiliation: College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA ChicagoENT, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Waxman
authors.affiliation: ChicagoENT, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.
authors.forename: Sreeya
authors.initials: S
authors.lastname: Yalamanchali
authors.affiliation: College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA ChicagoENT, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.
authors.forename: Elizabeth Shay
authors.initials: ES
authors.lastname: Valle
authors.affiliation: ChicagoENT, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pott
authors.affiliation: ChicagoENT, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA Rush University Medical Center, Chicago, Illinois, USA mfriedman@chicagoent.com.
authors.forename: Michael
authors.initials: M
authors.lastname: Friedman
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007013:Hypopharynx / Q000503:physiopathology; D057045:Laryngopharyngeal Reflux / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors
keywords: LPR symptoms; Reflux Symptom Index; laryngopharyngeal reflux; pH monitoring; pharyngeal pH