Gastroesophageal reflux and laryngitis: a skeptic's view

Gastroesophageal reflux disease (GERD) and laryngitis are common problems in the community. To prove a causal relationship between GERD and laryngitis, one must show the mechanism for acid-induced laryngitis, establish the frequency of association, have a gold standard for diagnosis of the condition, and show that treatment that reduces acid reduces laryngitis in double-blind, randomized, placebo-controlled trials. This article examines each of these components and finds that all are wanting as proof for reflux-induced laryngitis. The best approach to prove the association between GERD and laryngitis will likely lie in well-designed treatment trials.