Treatment of clinically diagnosed laryngopharyngeal reflux disease.

Abstract

OBJECTIVES:

To determine the incidence of Helicobacter pylori (HP) stool antigen (HPSA) in patients with laryngopharyngeal reflux disease (LPRD), and to make a comparison of 2 treatment regimens that have been used based on the presence or absence of HPSA positivity in patients with LPRD.

DESIGN:

Randomized controlled study.

SETTING:

Suez Canal University Hospital, Ismalia, Egypt.

PATIENTS:

A total of 212 patients with symptoms of LPRD.

INTERVENTION:

Patients were evaluated by laryngoscopy, ambulatory pH monitoring for 24 hours, and HPSA testing. Esomeprazole magnesium as a monotherapy was evaluated vs triple therapy in patients with HP infection.

MAIN OUTCOME MEASURES:

To determine the incidence of HPSA in patients with LPRD, and to make a comparison of 2 treatment regimens that have been used based on the presence or absence of HPSA positivity in patients with LPRD.

RESULTS:

Persistent dry cough and a feeling of a lump in the throat (globus sensation) were the most frequent symptoms of LPRD, while posterior laryngeal inflammation was the main laryngoscopic finding. Results from the HPSA test were positive in 57% of the studied group. Patients with negative HPSA were treated with esomeprazole as single modality with a reported improvement score of 96.6%. Patients with positive HPSA test results were divided into 2 groups: 1 received only esomeprazole, with reported improvement in 40%, whereas the second group was treated with esomeprazole, plus amoxicillin sodium and clarithromycin (triple therapy) and reported a 90% incidence of symptom improvement.

CONCLUSION:

The incidence of HP infection in patients with LPRD in our study was 57%. Triple therapy showed a higher cure rate in patients with HPSA-positive test results.

• Authors: Tarek Fouad Youssef, Mohamed Rifaat Ahmed
• Journal: Archives of otolaryngology--head & neck surgery (Arch Otolaryngol Head Neck Surg) Vol. 136 Issue 11 Pg. 1089-92 (Nov 2010) ISSN: 1538-361X [Electronic] United States
• PMID: 20855671 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Bacterial Agents
• Anti-Ulcer Agents
• Amoxicillin
• Clarithromycin
• Esomeprazole

Topics

• Adult
• Amoxicillin (therapeutic use)
• Anti-Bacterial Agents (therapeutic use)
• Anti-Ulcer Agents (therapeutic use)
• Clarithromycin (therapeutic use)
• Drug Therapy, Combination
• Egypt (epidemiology)
• Esomeprazole (therapeutic use)
• Female
• Helicobacter Infections (complications, drug therapy, epidemiology, microbiology)
• Helicobacter pylori
• Humans
• Incidence
• Laryngopharyngeal Reflux (drug therapy, epidemiology, microbiology)
• Laryngoscopy
• Male