PPIs May Improve Nasal Symptoms from Silent Reflux
05. 08. 2017
Proton pump inhibitors (PPIs) are one of the most common and effective treatments for gastroesophageal reflux disease (GERD), but new research finds that these medications may also alleviate nasal symptoms in patients with laryngopharyngeal reflux, also known as silent reflux.
Silent reflux is a digestive condition that occurs when stomach acid backs up into larynx, pharynx, sinuses, and even nasal passages. These areas are sensitive to harsh digestive fluids, and they become inflamed upon contact. Silent reflux produces symptoms not often associated with acid reflux, such as chronic throat clearing, postnasal drip, hoarseness, and excessive throat mucus.
Elif Dagli, MD, from Kecioren Training and Research Hospital, Ankara, Turkey, and colleagues performed a prospective observational case-controlled study to determine whether silent reflux is associated with nasal resistance and whether treatment alleviated nasal congestion. The study involved 50 participants with classic GERD symptoms who had also been diagnosed with silent reflux. These patients displayed evidence of a faulty lower esophageal sphincter (the muscular ring that acts as a barrier between the stomach and esophagus) and esophagitis. An additional 50 subjects with no history of silent reflux or nasal symptoms served as a control group.
The participants with silent reflux were given a twice-daily oral dose of the PPI pantoprazole for a period of 12 weeks. These patients were also advised on dietary changes and lifestyle modifications that could help manage their reflux symptoms.
Prior to the study, patients in the silent reflux group had higher Nasal Obstruction Symptom Evaluation (NOSE) and Total Nasal Resistance (TNR) scores than those in the control group. However, after 12 weeks of PPI treatment, these values were almost the same as those in the control group.
While these findings suggest that silent reflux is associated with nasal resistance and congestion, researchers are still unsure of the underlying mechanism. “[A]dditional clinical trials are needed to elucidate the pathophysiological processes that contribute to these respiratory changes,” said the authors.
The complete results of this study are published in the March 9 issue of JAMA Otolaryngology–Head & Neck Surgery (Source: Medscape).