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Expert Rev Gastroenterol Hepatol ; 10(9): 995-1004, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27137439

RESUMO

INTRODUCTION: Many patients experience ear, nose and throat symptoms associated with their gastroesophageal reflux disease. These symptoms are purportedly caused by reflux of gastroduodenal contents into the larynx, which leads to laryngopharyngeal reflux (LPR). Various modalities are used to diagnose LPR, including ambulatory pH monitoring, laryngoscopy, and esophagogastroduodenoscopy, as well as a few new emerging diagnostic tests. However, there are still no established diagnostic criteria or gold standard methodologies that can reliably distinguish LPR from other conditions. AREAS COVERED: In this review, we will evaluate currently available diagnostic tests and therapeutic options for patients with laryngeal signs and symptoms of reflux and briefly discuss the development and emergence of new treatments. Numerous studies have investigated the role of proton pump inhibitor therapy in this patient population, but have led to disparate and often inconsistent results. Expert commentary: While a subgroup of patients with LPR appears to respond to PPI therapy, many patients show no symptomatic improvement, particularly with respect to extraesophageal symptoms. As such, there is a vital need to explore alternative treatment options, including anti-reflux surgery, lifestyle changes, and other classes of medications to better address LPR.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório , Refluxo Laringofaríngeo/terapia , Inibidores da Bomba de Prótons/uso terapêutico , Comportamento de Redução do Risco , Quelantes/uso terapêutico , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Humanos , Refluxo Laringofaríngeo/diagnóstico , Refluxo Laringofaríngeo/etiologia , Refluxo Laringofaríngeo/fisiopatologia , Neurotransmissores/uso terapêutico , Valor Preditivo dos Testes , Inibidores da Bomba de Prótons/efeitos adversos , Indução de Remissão , Fatores de Risco , Resultado do Tratamento
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