Resolving the problem of how to treat LPR is not easy, and the philosophy on appropriate approaches will probably develop over the next few years. However, without good evidence-based data, finding clear answers will likely take longer than that.
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June 2013Controversies Surrounding the Management of Patients with Reflux Disease
- Whether there is a different pathophysiology of abnormal acid and pepsin exposure in patients with LPR versus GERD.
- Uncertainty of what constitutes abnormal pharyngeal acid exposure.
- The current practice of twice-daily PPI therapy in LPR is neither FDA approved nor based on controlled studies.
- The role of diagnostic testing and the continued role of acid/peptic reflux in those who remain symptomatic despite aggressive dose and duration of acid suppression.
Source: Altman KW, et al. Laryngoscope. 2011;121:717-723.