This retrospective cohort study (n=145) compared 4 treatments for laryngopharyngeal reflux disease (LPRD) over 3 months: strict antireflux diet plus stress reduction, proton pump inhibitors (PPIs), alginates, and magaldrate antacids. Diagnosis was confirmed by 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH testing.
All 4 groups showed significant symptom and sign improvement. The diet group had the highest responder rate (81.2%, 39/48) vs PPIs (56.3%, 18/32), alginates (57.9%, 22/38), and antacids (74.1%, 20/27). Diet was associated with 24.9 percentage points more responders than PPIs (95% CI, 4.6–45.4) and 23.4 points more than alginates (95% CI, 4.2–42.5). Diet also had significantly lower RSS scores than the antacid group (mean difference 38.73; 95% CI, 4.24–73.23), though the rate of change over time did not differ between groups.
- Retrospective design with non-random treatment allocation introduces selection bias. - Diet adherence was not objectively verified, and stress-reduction activities were self-reported. - Single-author study from 2 centers in Belgium and France limits generalizability.
For patients with confirmed LPRD, a strict antireflux diet combined with stress reduction may outperform PPIs and alginates in symptom response at 3 months — consider it as a first-line or adjunct option. Randomized trials are still needed before definitive practice change.
