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Proton pump inhibitor therapy for chronic laryngo-pharyngitis: a randomized placebo-control trial
David L Steward1, Keith M Wilson, Dan H Kelly
1Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, OH 45267-0528, USA. David.Steward@uc.edu
Objective:
To determine the efficacy of proton-pump inhibitor (PPI) therapy for chronic laryngo-pharyngitis treated with lifestyle modification.
Study Design And Methods:
Double-blind, randomized trial comparing two-month Rabeprazole (20 mg b.i.d.) to placebo control.
Results:
Compared to baseline, both PPI and control patients had significant improvement in total reflux symptoms (P = 0.002 and P = 0.03 respectively), with significant improvement in "laryngo-pharyngeal" but not "typical" reflux symptoms. No significant difference was noted for change in reflux symptoms between PPI-treated and control patients (P = 0.44). Significant global improvement was noted by 50% of control and 53% of PPI-treated patients (P = 1.0). No significant differences were noted within or between treatment groups for change in health status or videostrobolaryngoscopy grade. Lifestyle modification compliance correlated significantly with global improvement.
Conclusion:
Compared to baseline, lifestyle modification for 2 months significantly improved chronic laryngo-pharyngitis symptoms. When compared to control, treatment with a PPI failed to demonstrate significantly greater improvement in reflux symptoms, health status, or laryngeal appearance.
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