This article was submitted for presentation at the Triological Society Combined Section Meeting, January 27–30, 2011, Scottsdale, AZ.
Article first published online: 4 FEB 2011
Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 121, Issue 4, pages 717–723, April 2011
How to Cite
Altman, K. W., Prufer, N. and Vaezi, M. F. (2011), A review of clinical practice guidelines for reflux disease: Toward creating a clinical protocol for the otolaryngologist. The Laryngoscope, 121: 717–723. doi: 10.1002/lary.21429
The authors have no financial disclosures for this article.
The authors have no conflicts of interest to declare.
- Issue published online: 23 MAR 2011
- Article first published online: 4 FEB 2011
- Manuscript Accepted: 3 NOV 2010
- Manuscript Received: 18 AUG 2010
- Gastroesophageal reflux;
- laryngopharyngeal reflux;
- clinical practice guidelines;
- clinical protocol;
- Level of Evidence: 2a
Reflux disease, including gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR), is an extremely common condition that is diagnosed and treated routinely in an otolaryngology practice. There is great variability in the methods of both diagnosis and treatment amongst otolaryngologists. Our aim is to review current clinical practice guidelines on reflux disease, to identify areas of agreement and controversy, and to begin to work toward a clinical protocol for reflux disease for the otolaryngologist.
Literature review with discussion.
A PubMed search was performed looking for clinical practice guidelines on either GERD or LPR. Five hundred seventy articles were identified and the most clinically relevant practice guidelines were selected.
Thirteen key articles were identified. Eleven of these come from the gastroenterology literature, and none of them come from the otolaryngology literature. There appears to be a consensus on empiric medication trial as first-line therapy for presumed uncomplicated GERD and on prioritizing early identification of patients with severe disease complications. Areas of controversy include the definition of GERD and LPR, which diagnostic algorithm to use in which patient, and the long-term management of medical therapy.
Although there are many clinical aspects of reflux disease that still remain a mystery, there is enough literature to support a rudimentary clinical protocol at this time. As further data become available from outcomes measurements, such a protocol may result in improved quality and standardization. Laryngoscope, 2011