Combination drug therapy for laryngopharyngeal reflex

Abstract

Background: We sought to evaluate the combination of high-dose prebreakfast proton pump inhibitors (PPIs) (40 mg pantoprazole) and a bedtime high-dose ranitidine (300 mg) dosing as a surrogate and rational regimen for LPR. Methods: 60 subjects that presented to ENT and HNS OPD with symptoms of laryngopharyngeal reflux (LPR) were prospectively evaluated and underwent a comprehensive otolaryngological examination. All subjects were treated sequentially and outcomes recorded using reflux finding score (RFS) and reflux symptom index (RSI). Results: The mean age of the cohort was 35±06.51 (age range, 8-55). Mean RSI of all patients was 24.8 before treatment with combination of PPIs and H2 receptor antagonists. Significant change in RSI were observed after the first 8 weeks of therapy and no further significant changes were observed over the next 16 weeks. Mean RFS of the patients was 12 before starting the treatment and there was a significant response in mean RFS at 16 weeks of therapy. Conclusions: A surrogate high-dose prebreakfast PPI (40 mg pantoprazole) and a bedtime high-dose ranitidine (300 mg) dosing regimen is effective in improving RSI and RFS in majority of cases who present with LPR.