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Empirical treatment with pantoprazole as a diagnostic tool for symptomatic adult laryngopharyngeal reflux

Published online by Cambridge University Press:  28 February 2011

M Masaany ,
M B Marina ,
W P Sharifa Ezat  and
A Sani
M Masaany*
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Hospital Sultanah Bahiyah, Alor Setar, Malaysia
M B Marina
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
W P Sharifa Ezat
Affiliation:
Department of Public Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
A Sani
Affiliation:
Department of Otorhinolaryngology – Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
*
Address for correspondence: Dr Masaany Mansor, Department of ORL-HNS, Hospital Sultanah Bahiyah, 05460, Alor Setar, Malaysia Fax: 604 7407335 E-mail: [email protected]
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Abstract

Objective:

To determine the sensitivity and specificity of intensive empirical treatment with pantoprazole in diagnosing laryngopharyngeal reflux in adults.

Study design:

This was a prospective, double-blind study.

Subjects and methods:

Fifty-five patients with either a Reflux Symptom Index of more than 13 or a Reflux Finding Score of more than 7 were enrolled. All patients underwent 24-hour, double-probe pH monitoring before commencing pantoprazole 40 mg twice daily; both investigators and patients were blinded to pH monitoring results. The Reflux Symptom Index and Reflux Finding Score were reassessed during the second, third and fourth month of follow up.

Results:

The sensitivity of empirical pantoprazole treatment in diagnosing laryngopharyngeal reflux was 92.5 per cent. The specificity was 14.2 per cent, the positive predictive value 86 per cent and the negative predictive value 25 per cent. There was significant reduction in the total Reflux Symptom Index and Reflux Finding Score after the second, third and fourth month of treatment. There was no correlation between laryngopharyngeal reflux and body mass index.

Conclusion:

Our results suggest that intensive empirical treatment with proton pump inhibitors is effective in diagnosing laryngopharyngeal reflux.

Keywords

LaryngitisLaryngopharyngeal RefluxProton Pump InhibitorsTherapeutics
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 5 , May 2011 , pp. 502 - 508
Copyright
Copyright © JLO (1984) Limited 2011

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