Distinct Clinical Physiologic Phenotypes of Patients with Laryngeal Symptoms Referred for Reflux Evaluation

One third of adults experience laryngeal symptoms such as throat clearing and chronic cough 50-80% seeking care these are told that laryngopharyngeal reflux (LPR) is the etiology. LPR results from retrograde flow gastroduodenal contents to larynx pharynx; however, treatment presumed remains challenging with limited evidence-based guidance. This article summarizes @GIJournal Twitter discussion Yadlapati et al, “Distinct Clinical Physiologic Phenotypes Patients Laryngeal Symptoms Referred for Reflux Evaluation,” originally published in Gastroenterology Hepatology. In this study 302 patients referred evaluation, five distinct phenotypic groups were described, was only present two proposed phenotypes. GERD hiatal hernia (group A); mild LPR/GERD B); no LPR/no C); reflex D); mixed/possible obstructive esophagogastric junction (EGJ) E). Phenotypic differences can inform targeted clinical trials design improve outcomes.