Laryngopharyngeal Reflux and Atypical Gastroesophageal Reflux Disease

Gastrointest Endosc Clin N Am. 2020 Apr;30(2):361-376. doi: 10.1016/j.giec.2019.12.004. Epub 2020 Jan 22.

Abstract

Laryngopharyngeal reflux and atypical manifestations of gastroesophageal reflux disease have a high economic and social burden in the United States. There is increasing research supporting the reflex theory and hypersensitivity syndrome underlying this disease pathophysiology. Novel diagnostic biomarkers have gained more traction in the search for a more reliable diagnostic tool, but further research is needed. Current standard-of-care treatment relies on proton pump inhibitor therapy. Antireflux surgery is usually not recommended. Neuromodulators and treatments targeting specific neuronal receptors are discussed. A diagnostic algorithm is proposed for the evaluation of laryngeal symptoms suspected to be related to extraesophageal reflux disease.

Keywords: Chronic cough; Extraesophageal reflux disease; Laryngopharyngeal reflux.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Decision Support Systems, Clinical*
  • Diagnosis, Differential
  • Gastroesophageal Reflux / diagnosis*
  • Gastroesophageal Reflux / drug therapy
  • Humans
  • Laryngopharyngeal Reflux / diagnosis*
  • Laryngopharyngeal Reflux / drug therapy
  • Larynx / physiopathology
  • Neurotransmitter Agents / therapeutic use
  • Proton Pump Inhibitors / therapeutic use

Substances

  • Neurotransmitter Agents
  • Proton Pump Inhibitors