Management of laryngopharyngeal reflux disease

The management of laryngopharyngeal reflux (LPR) disease continues to evolve. Diagnostic strategies for LPR are moving away from pH probe testing, and relying more on empiric response to medical therapy with proton pump inhibitors. Both pH testing and empiric therapy have limitations, and no true "gold standard" diagnostic test exists for LPR. Medical therapy for gastroesophageal reflux disease and LPR is also undergoing re-evaluation, as up to 30% of patients continue to have abnormal reflux on standard proton pump inhibitors dosing regimens. Although surgical therapy for LPR is a promising option, the success of laparoscopic Nissen fundoplication (both short- and long-term) has yet to be rigorously evaluated for LPR patients.