Abstract
The 46 th statement in the Montreal Definition of Gastroesophageal Reflux Disease states as follows: In the absence of heartburn or regurgitation, unexplained asthma and laryngitis are unlikely to be related to GERD. However, the results of our retrospective analysis are not consistent with this statement. In our study, 167 suspected-LPR patients were treated with the continuous administration a single dose of a proton pump inhibitor for up to 6 months at Hokkaido University Hospital, Japan, for LPR symptoms between April 2004 and September 2006. Both laryngopharyngeal (throat clearing/annoying cough, voice problems, throat discomfort) and esophageal (heartburn/stomach acid reflux) symptoms were evaluated before and during the treatment using a score sheet modified from the Reflux Symptom Index as proposed by Belafsky. Esophageal symptoms were thus observed in 104 (62.3%) of 167 study patients. The Kaplan-Meier estimate for the laryngopharyngeal symptom-improvement rate showed a similar pattern between the heartburn/regurgitation (+) and (-) groups, thus indicating that, even in the absence of heartburn or regurgitation, acid suppressive therapy offers a comparable relief of LPR symptoms to those in the presence of esophageal symptoms.
