Usefulness of the Reflux Symptom Index and Reflux Finding Score in the Management of Laryngopharyngeal Reflux

Laryngopharyngeal reflux (LPR) refers to a condition in which gastroduodenal contents reflux back into the oesophagus and affects the throat, specifically the laryngopharynx. A wide variety of symptoms have been attributed to LPR. To minimize the underdiagnosis, Reflux Symptom Index (RSI) with the Reflux Finding Score(RFS) are useful in ENT practice. LPR treatment typically entails an intensive strategy, applied over an extended period of time, combined with dietary adjustments, exercise, weight loss and lifestyle changes. To study the usefulness of Reflux Symptom Index and Reflux Finding Score in the management of LPR. This study was a descriptive study conducted in the Department of ENT, Bangalore Medical College and Research Institute, Bangalore from February 2021 to August 2022. This study included 90 patients who were diagnosed to have LPR attending the ENT OPD at Bangalore Medical College and Research Institute, Bangalore and attached hospitals. All patients were subjected to detailed history taking using RSI, thorough clinical examination and laryngoscopic examination using RFS and necessary investigation was done. They were treated with proton pump inhibitors and prokinetic drugs and followed up regularly. Treatment was stopped after 6 months to prevent long-term adverse. Our study recruited 90 patients who were diagnosed to have LPR of which 55 were male and 35 female. Most of them were 41-50 years of age. Throat clearing was found to be the most common symptom and erythema/ hyperaemia of larynx was the most common sign. It was found that median RSI score was highest at baseline (13) and lowest 2 months (2) with no RSI score at 3 and 6 months. The median RFS scores was highest at baseline (8) and lowest after 2 months (1) with no RFS score at 3rd and 6th months. The difference was statistically significant. Major improvement in symptoms was seen after 2nd month and major improvement in laryngoscopic signs was seen after 1st month. RSI and RFS are useful diagnostic tools in identifying patients with LPR. It helps in assessing response to treatment during their follow up. Treatment with proton pump inhibitors and prokinetic drugs along with strict dietary modification, stress management and regularization of life style has to be followed for a duration of 6 months with regular follow up for complete resolution of signs and symptoms.