Psychosocial Interventions in Laryngopharyngeal Reflux: An Institutional Experience.

INTRODUCTION

Laryngopharyngeal reflux (LPR) results from the retrograde flow of gastric contents into the upper aerodigestive tract, causing chronic cough, throat clearing, and dysphonia. Unlike gastroesophageal reflux disease (GERD), LPR lacks typical oesophageal symptoms, complicating diagnosis and treatment. Proton pump inhibitors (PPIs) are commonly prescribed but show inconsistent efficacy. Psychological distress, including anxiety and depression, may contribute to LPR symptom persistence, yet few studies have examined psychosocial interventions in LPR management.

METHODOLOGY

This prospective, observational cohort study was conducted over two years (January 2022- December 2024) at a tertiary care hospital. A total of 100 LPR patients were assigned to a Standard Treatment Group (pharmacological and dietary therapy) or a Psychosocial Intervention Group (receiving additional Cognitive-Behavioural Therapy (CBT) and Mindfulness-Based Stress Reduction (MBSR)). LPR severity (Reflux Symptom Score [RSS] and Reflux Sign Assessment [RSA]) and psychological distress (GAD-7, PHQ-9, PSS) were assessed at baseline and 3, 6, 12, and 24 months.

RESULTS

The Psychosocial Intervention Group showed greater symptom reduction (RSS: 7.8 ± 1.3 vs. 5.2 ± 1.1,  = 0.012; RSA: 5.6 ± 1.0 vs. 3.8 ± 0.9,  = 0.009). Psychological distress scores declined significantly ( < 0.01). The intervention improved treatment response (85% vs. 65%) and quality of life (70% vs. 50%). Regression analysis identified psychological distress as a predictor of treatment resistance, while psychosocial interventions improved likelihood of symptom resolution (OR = 2.54,  < 0.001).

CONCLUSION

Psychosocial distress significantly influences LPR severity and treatment outcomes. Integrating CBT and MBSR with standard therapy enhances symptom relief and quality of life, supporting a multidisciplinary treatment approach.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12070-025-05493-6.