Alginates and laryngopharyngeal reflux: where we stand. A systematic review

Laryngopharyngeal reflux (LPR) is a medical condition in which gastric contents reflux, directly or indirectly, causing morphological and neurological alterations in the upper aerodigestive system. Alginates are a common solution to this problem.

We conducted a PRISMA-compliant systematic review of the MEDLINE (via PubMed), Cochrane Central Register for Controlled Trials, and Scopus databases without temporal limitations. Our goal was to gather all available data published in English on the use of alginates in patients with LPR.

A total of 134 articles were screened, and 16 met the inclusion criteria. The included studies comprised three surveys, one experience study, four observational cohort studies, two cross-sectional studies, one case series, four experimental randomized studies, and one non-randomized study. The remaining 12 clinical studies enrolled a total of 994 individuals, including 274 patients with both LPR and dry eye syndrome in two of these studies. Three key themes emerged from the included texts: decision-making and awareness among clinicians treating patients with LPR regarding alginate use, the effect of alginates in treating LPR symptoms, the effect of alginates in patients with both LPR and dry eye syndrome. The main outcome measures in the clinical studies on LPR patients included RSS, RSA, RSI, RFS, symptom resolution, VAS scores, treatment tolerance, and drug-related adverse events.

Alginates demonstrate a beneficial role both as monotherapy and as adjunct therapy with proton pump inhibitors (PPIs). Larger randomized studies are needed to further define their effectiveness in treating LPR.