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Invited Commentary
September 7, 2017

Dietary Modifications in the Treatment of Laryngopharyngeal Reflux—Will “an Apple a Day” Keep the Laryngopharyngeal Reflux Away?

Author Affiliations
  • 1Center for Esophageal Diseases, Section of Gastroenterology, Hepatology, and Nutrition, University of Chicago, Chicago, Illinois
JAMA Otolaryngol Head Neck Surg. Published online September 7, 2017. doi:10.1001/jamaoto.2017.1449

Laryngopharyngeal reflux (LPR) can manifest as a number of symptoms that can be challenging for patients to tolerate and for physicians to effectively diagnose and treat. These symptoms have been shown to lead to extensive health care costs, with annual costs in the United States suggested to be as high as over $50 billion, a significant component of which is owing to the use of proton pump inhibitors (PPIs).1 Not only is this a challenging condition to both define and diagnose, but in the absence of a gold standard diagnostic tool it is also challenging to monitor response to therapy. The Reflux Symptom Index (RSI) is a validated 9-item self-administered questionnaire published in 2002 to assess the severity of LPR symptoms; however, its clinical utility has been questioned and responses are of a subjective nature.2,3

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