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Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians

Laryngopharyngeal reflux (LPR) is a common disease in the general population with acute or chronic symptoms. LPR is often misdiagnosed in primary care because of the lack of typical gastroesophageal reflux disease (GERD) symptoms and findings on endoscopy. Depending on the physician’s specialty and...

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Autores principales: Lechien, Jerome R., Saussez, Sven, Muls, Vinciane, Barillari, Maria R., Chiesa-Estomba, Carlos M., Hans, Stéphane, Karkos, Petros D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697179/
https://www.ncbi.nlm.nih.gov/pubmed/33182684
http://dx.doi.org/10.3390/jcm9113618
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author Lechien, Jerome R.
Saussez, Sven
Muls, Vinciane
Barillari, Maria R.
Chiesa-Estomba, Carlos M.
Hans, Stéphane
Karkos, Petros D.
author_facet Lechien, Jerome R.
Saussez, Sven
Muls, Vinciane
Barillari, Maria R.
Chiesa-Estomba, Carlos M.
Hans, Stéphane
Karkos, Petros D.
author_sort Lechien, Jerome R.
collection PubMed
description Laryngopharyngeal reflux (LPR) is a common disease in the general population with acute or chronic symptoms. LPR is often misdiagnosed in primary care because of the lack of typical gastroesophageal reflux disease (GERD) symptoms and findings on endoscopy. Depending on the physician’s specialty and experience, LPR may be over- or under-diagnosed. Management of LPR is potentially entirely feasible in primary care as long as General Practitioners (GPs) are aware of certain “red flags” that will prompt referral to a Gastroenterologist or an Otolaryngologist. The use of patient-reported outcome questionnaires and the consideration of some easy ways to diagnose LPR without special instrumentation oropharyngeal findings may help the GP to diagnose and often manage LPR. In this review, we provide a practical algorithm for LPR management for GPs and other specialists that cannot perform fiberoptic examination. In this algorithm, physicians have to exclude some confounding conditions such as allergy or other causes of pharyngolaryngitis and “red flags”. They may prescribe an empirical treatment based on diet and behavioral changes with or without medication, depending on the symptom severity. Proton pump inhibitors and alginates remain a popular choice in order to protect the upper aerodigestive tract mucosa from acid, weakly acid and alkaline pharyngeal reflux events.
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spelling pubmed-76971792020-11-29 Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians Lechien, Jerome R. Saussez, Sven Muls, Vinciane Barillari, Maria R. Chiesa-Estomba, Carlos M. Hans, Stéphane Karkos, Petros D. J Clin Med Review Laryngopharyngeal reflux (LPR) is a common disease in the general population with acute or chronic symptoms. LPR is often misdiagnosed in primary care because of the lack of typical gastroesophageal reflux disease (GERD) symptoms and findings on endoscopy. Depending on the physician’s specialty and experience, LPR may be over- or under-diagnosed. Management of LPR is potentially entirely feasible in primary care as long as General Practitioners (GPs) are aware of certain “red flags” that will prompt referral to a Gastroenterologist or an Otolaryngologist. The use of patient-reported outcome questionnaires and the consideration of some easy ways to diagnose LPR without special instrumentation oropharyngeal findings may help the GP to diagnose and often manage LPR. In this review, we provide a practical algorithm for LPR management for GPs and other specialists that cannot perform fiberoptic examination. In this algorithm, physicians have to exclude some confounding conditions such as allergy or other causes of pharyngolaryngitis and “red flags”. They may prescribe an empirical treatment based on diet and behavioral changes with or without medication, depending on the symptom severity. Proton pump inhibitors and alginates remain a popular choice in order to protect the upper aerodigestive tract mucosa from acid, weakly acid and alkaline pharyngeal reflux events. MDPI 2020-11-10 /pmc/articles/PMC7697179/ /pubmed/33182684 http://dx.doi.org/10.3390/jcm9113618 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Lechien, Jerome R.
Saussez, Sven
Muls, Vinciane
Barillari, Maria R.
Chiesa-Estomba, Carlos M.
Hans, Stéphane
Karkos, Petros D.
Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians
title Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians
title_full Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians
title_fullStr Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians
title_full_unstemmed Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians
title_short Laryngopharyngeal Reflux: A State-of-the-Art Algorithm Management for Primary Care Physicians
title_sort laryngopharyngeal reflux: a state-of-the-art algorithm management for primary care physicians
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7697179/
https://www.ncbi.nlm.nih.gov/pubmed/33182684
http://dx.doi.org/10.3390/jcm9113618
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