[Evaluation of efficacy of esomeprazole treatment in patients with laryngopharyngeal reflux].

OBJECTIVE

To evaluate the efficacy of proton pump inhibitor (PPI) therapy with esomeprazole on laryngopharyngeal reflux (LPR) by pepsin immunoassay in the sputum.

METHOD

From June 2009 to March 2010, patients in the ENT outpatient department of Nanfang hospital with a reflux finding score (RFS) >7 and a reflux symptom index (RSI) >13 were selected. Their sputum was obtained in the morning for pepsin assay. Twenty-six patients with positive results of pepsin assay were enrolled and received esomeprazole 20 mg twice daily for two months. They paid return visits every two weeks. RSI, RFS and pepsin concentration in the sputum were assessed at baseline and after two months. Pepsin in the sputum was measured by enzyme linked immunoadsorbent assay.

RESULT

After 8 weeks, 24 patients got symptom improvements except 2. All got improved results of laryngoscope exams. RSI and RFS scores before and after PPI treatment reached statistical signification by paired t-test (t= 8.152, P<0.01; t=9.704, P<0.01). 21 patients' pepsin concentrations decreased except 5. Nonparametric tests were used because the reduction of pepsin concentrations before and after PPI treatment were not normally distributed (Z=-3.213, P<0.01). Reductions of total RSI and RFS scores as well as pepsin concentrations were significantly higher after two months.

CONCLUSION

Twice-daily PPI treatment for two months demonstrated a significantly greater improvement in laryngeal appearance and LPR symptoms for most patients in this study, which can result in significantly decreased levels of pepsin in sputum.