Chronic Laryngitis and Gastroesophageal Reflux Disease

78 INTRODUCTION Gastroesophageal reflux disease (GERD) is implicated in many patients with chronic laryngitis. Ear, nose and throat (ENT) physicians often refer to this condition as laryngopharyngeal reflux (LPR) representing the retrograde movement of gastric contents, including acid, pepsin as well as bile acids, into the laryngopharynx (1,2). Typical LPR symptoms include dysphonia, globus pharyngeus (sensation of lump in throat), mild dysphagia, chronic cough, and non-productive throat clearing (Table 1). There are many synonyms for LPR including extraesophageal reflux, reflux laryngitis, and laryngeal reflux. There is currently no gold-standard in the diagnosis of LPR, and hence data on its epidemiology is limited. One study of 105 normal, healthy, adults revealed at least one finding associated with reflux during a laryngoscopy in 86% of the volunteers (3). In a metaanalysis which reviewed the data of pH probe readings in patients with LPR and in controls, 10% to 60% of the control patients (totaling 264 in number) demonstrated reflux (4). Studies such as these reveal that LPR or what is thought to be LPR is a common occurrence in the general population; however, it may be over diagnosed in some patients. In this review we will highlight the current knowledge and controversy in LPR and discuss current treatment options.