Diet Therapy an Effective Alternative to Medication in Some Patients with Laryngopharyngeal Reflux

by Linda Kossoff •

How effective is a low-fat, low-quick-release sugar, high-protein, alkaline, and plant-based diet as a single treatment for patients with laryngopharyngeal reflux (LPR)?

BOTTOM LINE

A low-fat, low-quick-release sugar, high-protein, alkaline, and plant-based diet is an alternative cost effective therapeutic approach for patients with LPR.

BACKGROUND: Laryngopharyngeal reflux is an inflammatory condition whose etiology is poorly understood. However, diet may play a role in the occurrence of esophageal dysmotility, sphincter insufficiency, and related pharyngeal reflux events. Most otolaryngologists treat patients with suspected LRP with proton pump inhibitors, but these have associated health risks.

STUDY DESIGN: Crossover observational study.

SETTING: Department of Otolaryngology–Head and Neck Surgery, Foch Hospital, School of Medicine, University Paris Saclay, Paris, France.

SYNOPSIS: From December 2019 to June 2021, researchers prospectively recruited patients from the reflux clinics of three hospitals. Patients with symptoms and signs of LPR received 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH-monitoring off of acid-suppressive medication. Those with heartburn or gastroesophageal reflux disease and elderly individuals received upper glycemic index endoscopy to detect other conditions. Patients diagnosed with LPR were instructed to follow a low-fat, low-quick-release sugar, high-protein, alkaline, and plant-based diet for six to 12 weeks. Pre- to post-treatment symptoms and changes were evaluated with reflux symptom score and reflux sign assessment. Diet was evaluated with refluxogenic diet scores. Of the 50 patients who completed the study (31 females, mean age 52.3 years), 37 (74%) reported significant symptom improvement or relief at six weeks post-diet. Moreover, 27 patients of the 37 who had improved at six weeks showed continuing improvement from six to 12 weeks. Both diet and stress (the latter assessed via a 10-point Likert scale) were predictive of symptom severities at baseline and throughout treatment. Study limitations included a lack of placebo or control intervention.

CITATION: Lechien JR, Crevier-Buchman L, Distinguin L, et al. Is diet sufficient as laryngopharyngeal reflux treatment? Laryngoscope. 2022;132:1916–1923.