Treatment of Laryngopharyngeal Reflux May Decrease Subjective Symptoms of Nasal Congestion and Objective Measures of Nasal Resistance

Gastroesophageal reflux disease (GERD) is highly prevalent, and its most common symptoms, including heartburn and regurgitation, may be present in up to 45% of the population. Laryngopharyngeal reflux (LPR) is an extraesophageal manifestation of GERD that may be present in up to 10% of patients presenting for ambulatory otolaryngology visits. Typical symptoms that have been attributed to LPR include globus sensation, laryngospasm, throat clearing, and hoarseness. Moreover, it has been postulated that mucosal inflammation due to LPR may extend beyond the larynx and oropharynx to the nasopharynx and nasal cavity, contributing to the pathogenesis of sinonasal diseases. For example, an association between chronic rhinosinusitis (CRS) and GERD has been shown through epidemiologic studies that have found high rates of pharyngeal reflux in CRS, as well as the finding of digestive enzymes in the nasal secretions of patients with CRS. Despite this, few studies have objectively examined the effect of treatment of LPR on sinonasal symptoms.

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